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Background and Objective: Myofascial pain syndrome is one of the painful conditions of the musculoskeletal system. There is controversy about the effectiveness of treatment strategy. This study was done to compare the effects of diclofenac phonophoresis with ergonomic instructions on neck and shoulder pain and disability in women with myofascial trigger points in trapezius muscle. Materials and Methods: This clinical trial study was conducted on thirty female students with trigger points in trapezius muscle in Razmejo-Moghadam Physiotherapy Clinic, Zahedan University of Medical Sciences, Iran during 2009. Patients were randomly assigned to one of three equal groups: diclofenac phonophoresis, ergonomic instructions, and control groups. In phonophoresis group, after applying diclofenac gel, ultrasound with frequency of 1 MHz, continuous mode, intensity 1.5 W/cm2, and duration 4.5 min was used. Ergonomic group received instructions in order to maintain appropriate posture during activity of daily life. Control group received ultrasound without output. A 12 session treatment program, during 4 weeks, 3 sessions per week was performed. Neck pain was assessed before and after intervention with Northwick Park Neck Pain Questionnaire and shoulder pain and disability with Shoulder Pain and Disability Index. Data were analyzed using SPSS-17, Kolmogorov-Smirnov, paired t-test, One-way ANOVA and Tukey tests. Results: Neck pain score decreased from 18±3.5 to 7.6±4.4 in phonophoresis group and from 17.8±3.5 to 10.5±3.4 in ergonomic group (P<0.05). Also, shoulder pain and disability score decreased from 106.2±28.1 to 36.76±30.7 in phonophoresis group and from 103.3±22.9 to 26.2±12.3 in ergonomic group (P<0.05). There was no significant difference between post and pretreatment results in control group. After treatment, there was no significant difference between two treatment groups regarding neck, shoulder pain and disability. However, after treatment there was significant difference between two treatment groups and control group regarding pain (P<0.05). Conclusion: This study showed that diclofenac phonophoresis and ergonomic instructions are effective in decreasing neck and shoulder pain and disability in patients with myofascial trigger points in trapezius muscle. None of both treatment strategy was superior to other.

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Background and Objective: Musculoskeletal disorder is a professional disease which is due to undesirable work condition and is a disturbing factor of health and welfare in societies. This study was carried out to determine the prevalence of musculoskeletal disorders in nurses and its relationship with the knowledge of ergonomic and environmental factors in north of Iran. Methods: This descriptive-analytic study was carried out on 110 nursing staff in Razi and Imam Khomeini hospitals in north of Iran. Questionnaire of the rate of awareness measurement, general questionnaire of musculoskeletal diseases (Nordik), the questionnaires of the health status and the study relationships between some factors in work place were filled out for each nurse. Results: Prevalence of the pain in neck, back, low back, shoulder, knee, thing pain, arm, leg among nurses was 50%, 49%, 58%, 44.9%, 47.3%, 32.7%, 36.4% and 56.4%, respectively. The condition of work place including air filtration (23.6%), light (22.7%) and air condition (4.5%) was not well. Chair (31%) and work table (34%) for work condition and body position of nurses was unsuitable. There was a significant relationship between low back pain and age and time of working per week of nurses (P<0.05). Nurses knowledge in the filed ergonomy was 77% and 22.2% of nurses trained in body condition during work. 60% of nurses were not trained for correct patient transportation and relocation. Conclusion: Nurses suffered more from pain in low back, knee, neck and legs. Training of nurses for patient transportation and body position during working in hospital is essential.