Physical therapy intervention in patients with non-cardiac chest pain following a recent cardiac event: A randomized controlled trial

OBJECTIVES To assess the effect of two different physical therapy interventions in patients with stable coronary heart disease and non-cardiac chest pain. METHODS A randomized controlled trial was carried out at a university hospital in Norway. A total of 30 patients with known and stable coronary heart disease and self-reported persistent chest pain reproduced by palpation of intercostal trigger points were participating in the study. The intervention was deep friction massage and heat pack versus heat pack only. The primary outcome was pain intensity after the intervention period and 3 months after the last treatment session, measured by Visual Analogue Scale, 0 to 100. Secondary outcome was health-related quality of life. RESULTS Treatment with deep friction massage and heat pack gave significant pain reduction compared to heat pack only (-17.6, 95% confidence interval: -30.5, -4.7; p < 0.01), and the reduction was persistent at 3 months' follow-up (-15.2, 95% confidence interval: -28.5, -1.8; p = 0.03). Health-related quality of life improved in all three domains in patients with no significant difference between groups. CONCLUSION Deep friction massage combined with heat pack is an efficient treatment of musculoskeletal chest pain in patients with stable coronary heart disease.