Treatment of Pectoralis Trigger Points in Patients With Pseudo Angina

NCT07728357 | Not Yet Recruiting

• 1 other identifier: TUF/EIRB/136/2025
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

Pseudo-angina is a musculoskeletal condition characterized by chest pain that resembles angina but occurs due to non-cardiac causes, particularly myofascial trigger points in the chest wall muscles. Trigger points in the pectoralis major and minor muscles may contribute to pain, discomfort, and functional limitations by affecting muscle activity and movement. Manual therapy techniques such as the Graston Technique and Local Ischemic Compression (LIC) are commonly used to manage soft tissue dysfunction and myofascial trigger points. This study aims to compare the effects of the Graston Technique and Local Ischemic Compression on pain reduction and functional improvement in patients with pseudo-angina.

Conditions

Pseudo Angina; Myofascial Pain Syndromes; Pectoralis Muscles; Musculoskeletal Chest Pain

Keywords

chest pain; Non-cardiac chest pain; Myofascial pain syndrome; Graston Technique; Instrument-assisted soft tissue mobilization; Chest wall pain; Musculoskeletal chest pain; Local Ischemic Compression

Outcome Measures

Primary Outcomes (2)

• Shoulder Pain Disability Index

  The Shoulder Pain and Disability Index is a well-known neutral measure for assessing the level of pain and functional impairment experienced by people with shoulder issues. It is frequently used in clinical and research settings to assess the severity of shoulder problems and track therapy efficacy. It consists of 13 elements organized into two subscales. The Pain Subscale consists of five items that determine how intense pain is in various circumstances, such as at rest or during activities. The disability subscale consists of eight items: it assesses the level of difficulty with specific everyday shoulder-related tasks, such as lifting weights or putting on a shir

  Baseline and 4 week post intervention

• Numeric Pain Rating Scale

  NPRS was used as a primary outcome measure to evaluate pain intensity in patients with pseudo-angina. On the scale, 0 represents no discomfort and 10 represents severe pain. At rest and while engaging in activities, participants were asked to rate their level of pain.

  Baseline and 4 week post intervention

Study Arms (2)

Graston Technique

EXPERIMENTAL

articipants assigned to this arm received the Graston Technique, an instrument-assisted soft tissue mobilization intervention, applied to the identified myofascial trigger points of the pectoralis major and pectoralis minor muscles. The intervention was performed after a gentle Z-stretch of the targeted muscles as baseline treatment. A stainless-steel Graston instrument was applied using controlled strokes at approximately a 45° angle to the skin surface, following the direction of the muscle fibers and across the fibers to mobilize soft tissue restrictions. The treatment was applied for approximately 40-120 seconds over each targeted area.

Other: Graston Technique

Local Ischemic Compression

EXPERIMENTAL

Participants assigned to this arm received LIC applied to the identified myofascial trigger points of the pectoralis major and pectoralis minor muscles. Following a gentle Z-stretch of the targeted muscles as baseline treatment, sustained manual pressure was applied gradually over each trigger point until a tolerable level of discomfort was achieved. The compression was maintained for approximately 90 seconds per trigger point and repeated 1-3 times during each treatment session according to patient tolerance and clinical response. The technique was performed using the therapist's thumb, finger, or knuckle depending on the location and depth of the trigger point. Participants received four physiotherapy sessions over a two-week period, with sessions conducted on alternate days.

Other: Local Ischemic Compression

Interventions

Graston Technique OTHER

A stainless-steel Graston instrument was applied using controlled strokes at approximately a 45° angle to the skin surface, following the direction of the muscle fibers and across the fibers to mobilize soft tissue restrictions. The treatment was applied for approximately 40-120 seconds over each targeted area.

Graston Technique

Local Ischemic Compression OTHER

Sustained manual pressure was applied gradually over each trigger point until a tolerable level of discomfort was achieved. The compression was maintained for approximately 90 seconds per trigger point and repeated 1-3 times during each treatment session according to patient tolerance and clinical response. The technique was performed using the therapist's thumb, finger, or knuckle depending on the location and depth of the trigger point

Local Ischemic Compression

Eligibility Criteria

• Age: 25 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Participants which fulfill the Simon's Trigger Point Diagnostic Criteria
• Referred by Cardiologist • Patients with Trigger Points in chest Muscles and left Pectoralis Major and Minor muscles.

You may not qualify if:

• Spinal Deformity • Gastric Problems • Any cardiac disease • Heart Burns • Panic Attacks • Pleurisy • Pulmonary Embolism • Pericarditis.

Sponsors & Collaborators

• University of Faisalabad: lead

Study Sites (1)

The University of Faisalabad

Faisalābad, Punjab Province, 38000, Pakistan

Location

Related Publications (2)

• This citation will not be hyperlinked on ClinicalTrials.gov. The effectiveness of instrument- assisted soft tissue mobilization technique (ergonš technique), cupping and ischaemic pressure techniques in the treatment of amateur athletes΄ myofascial trigger points. Journal of Novel Physiotherapy S (3): 1-7.

  BACKGROUND

• This citation wilnot be hyperlinked on ClinicalTrails.gov. Fousekis K, Kounavi E and Doriadis S (2016) The Effectiveness of instrument- assisted soft tissue mobilization technique, cupping and ischemic pressure techniques in the treatment of amateur athlete's myofascial trigger points. Journal of Novel Physiotherapies 3(2): 1-7.

  BACKGROUND

MeSH Terms

Conditions

Myofascial Pain Syndromes; Chest Pain

Condition Hierarchy (Ancestors)

Muscular Diseases; Musculoskeletal Diseases; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Central Study Contacts

Dr. Muhammad Muneeb Jafar, PhD Physical therapy

CONTACT

+923127000616; muneebjafar.DPT@tuf.edu.pk

Dr Maryam Farooq, Phd Physical therapy

CONTACT

+923326760155; Maryamfarooq2527@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor, Department of Rehabilitation Sciences

Study Record Dates

• First Submitted: July 22, 2026
• First Posted: July 27, 2026
• Study Start: July 25, 2026
• Primary Completion (Estimated): October 1, 2026
• Study Completion (Estimated): November 1, 2026
• Last Updated: July 27, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)