About this trial

The goal of this clinical trial is to conduct MRI studies on adults with myofascial pain syndrome (MPS) to identify important MRI biomarkers that respond to OMT (osteopathic manipulation therapy) and investigate the feasibility of implementing MRI study and OMT in this population. The main outcomes of the study include:

* Determine whether biomarkers measured by MRI can differentiate normal tissues and MTrP (myofascial trigger point). * Test the responsiveness of the biomarkers identified by MRI to the proposed intervention, OMT, in patients with MPS of the upper back.

Researchers will compare participants who will receive one session of OMT (Group 1 - Experimental Condition) and participants who will not receive any treatment (Group 2 - Control Condition) to see how the MRI-identified biomarkers respond to the intervention.

Participants will complete the following:

* Clinical screening * MRI measures * Battery of self-report surveys * Clinical/Physical Function Assessment

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

MPS of the upper back with MTrPs as specified by Travell and Simons, with the confirmation of ultrasound procedure.

Normal neurological examination including manual muscle testing, sensory exam, and deep tendon reflexes.

English-speaking.

Age 18 - 64 and reside in the community.

Disqualifiers

Malignancy.

Major psychiatric disorders, such as bipolar disorder and depression.

Cognitive impairment

Skin lesion(s) on the shoulders and upper back.

Trial design

Design model

Parallel

Treatments tested in this trial

Osteopathic Manipulation Treatment - Scapular Release
Other intervention
First, the patient will be positioned in the supine position. The physician or trained fellow will then place his/her hands on the medial border of the scapula on the affected side. From the paraspinal fascia to the medial border of the scapula a lateral traction is added along with a superior to inferior traction and additionally an inferior to superior traction. The shoulder will be used as an additional fulcrum by having the shoulder in the forward flexion position at 90 degrees and then adduction of the humerus to aid in addition movement of the scapula by moving the upper arm into adduction and abduction in a rhythmic motion. The treatment with a rhythmic and/or static traction in the motions described above and manual movement of the scapula will be done for a maximum of 15 minutes.

Treatment groups

20 Participants

are divided into 2 treatment groups

Group A: Group 1 - One session of OMT InterventionExperimental treatment 1 intervention

Group B: Group 2 - No interventionNo intervention 0 interventions

Trial outcomes

Primary outcomes

1

MRI Biomarkers - Structural MRI

3D T1- weighted images (TR (repetition time) = 7 ms, TE (echo time) = 2.4 ms, resolution 0.6 mm3, flip angle = 20°, bandwidth = 790 Hz/pixel) will be used for high-resolution structural imaging. T2 maps will be obtained with T2 prepared gradient-echo (GRE) sequence with centric ordered k- space trajectory. T2 preparation duration will be varied from 24 ms to 84 ms in increments of 10 ms with sequence TR (time between consecutive T2 preps) = 3000 ms. The GRE acquisition parameters will be TR = 7 ms, flip angle = 6° (small flip angle to minimize T1 weighting), and resolution 0.6 mm 3 . T2 and proton density maps will be computed by voxel-wise non-linear fitting to mono-exponential T2 decay.

Time frame