Comparative evaluation of effectiveness of Muscle Relaxants and muscle relaxants in adjunct with Bhramari pranayama, in patients of Myofascial Pain Dysfunction Syndrome of Nashik region: A Randomized Control Trial

Abstract

AbstractObjective: To compare the effectiveness of muscle relaxant alone versus muscle relaxant with Bhramari pranayama in reducing pain and muscle tenderness in patients of Myofascial Pain Dysfunction Syndrome.Methods: This pilot randomized controlled trial included 20 MPDS patients from Nashik region, allocated into Group A: Myospaz Forte (thiocolchicoside 4 mg + paracetamol 500 mg) twice daily for one week, n=10 and Group B: Myospaz Forte + Bhramari pranayama 15 min/day n=10, for 28 days. Visual Analog Scale and Palpation Index were assessed at baseline, Day 7, 14, 21, 28. Data were analysed using Friedman test for intragroup and Mann Whitney U test for intergroup comparison. ANCOVA adjusted for baseline was performed.Results: Both groups showed significant intragroup reduction in VAS and Palpation Index over 28 days (p<0.001). Group B demonstrated significantly lower VAS than Group A at Day 7 (4.0±1.1 vs 6.0±1.2; p=0.003), Day 14 (3.0±1.0 vs 5.0±1.3; p=0.002), Day 21 (3.0±1.2 vs 6.0±1.4; p<0.001), and Day 28 (2.0±0.9 vs 4.0±1.1; p=0.001). Palpation Index reached 0 at Day 14–21 in Group B only, with significant intergroup differences at all time points (p<0.01). After ANCOVA adjustment, Group B maintained significantly greater improvement at Day 28.Conclusions: Adjunctive Bhramari pranayama provides superior and sustained reduction in pain and tenderness compared to muscle relaxant alone in MPDS. Significance: Integrating cost-free yogic breathing with pharmacotherapy offers an effective, holistic model for MPDS management by addressing both muscular and stress-related aetiologies.