The study focuses on trigger points (TrPs) in the upper trapezius muscle, which are hyperirritable spots in skeletal muscle that are associated with localized pain and discomfort. These TrPs can lead to a variety of symptoms, including muscle stiffness, restricted range of motion, and referred pain in the neck and shoulder regions. The presence of active TrPs in the upper trapezius is commonly linked to musculoskeletal disorders, particularly in individuals with poor posture, repetitive movement
Conditions
Interventions
Intervention 1: Intervention group 1: dry needling: Deep dry needling (DDN) will be used to treat the participants throughout six sessions. The patients will be told to lie down with their heads in a
Sponsors
Tehran University of Medical Sciences
Eligibility
Sex/Gender
All
Age
20 Years to 50 Years
Inclusion criteria
Inclusion criteria: patients aged 20–50 years. patients with spontaneous pain or pain with movement in the neck and shoulder region related to active TrPs localized in the unilateral upper trapezius muscle patients with symptom duration of at least three months patients presenting a pain score equal to or higher than four in either rest or activity cervical spinal motion willingness to participate in the study Presence of 1 to 3 trigger points in one side. Intact vision and auditory
Exclusion criteria
Exclusion criteria: history of whiplash injury previous cervical surgery cervical radiculopathy/myelopathy fibromyalgia having undergone any physical therapy intervention in the previous 6 month fear of needles any contraindication for DN, for example, anticoagulants or psychiatric disorders. Cervicogenic headache
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome variable for this study is pain intensity, which will be assessed using the Visual Analog Scale (VAS). This variable is chosen as the primary outcome because pain is a key clinical symptom of upper trapezius trigger points (TrPs) and is expected to change as a result of the interventions. The sample size calculation is based on the effect size related to changes in pain intensity following treatment with dry needling (DN) and kinesio taping (KT). Changes in pain intensity will help evaluate the effectiveness of the combined intervention on alleviating the discomfort caused by TrPs in the upper trapezius muscle. Timepoint: Before intervention (baseline)10 days after baseline (midpoint)3 weeks after baseline. Method of measurement: Visual analog scale (VAS) pain scale: The Visual Analog Scale (VAS) consists of a 100 mm continuous line with "no pain" at one end, representing a score of 0, and "worst possible pain" at the other end, representing a score of 100. The score is determined by measuring the distance (mm) between the two endpoints, and it is categorized as follows: no pain at 0-4 mm, mild pain at 5-44 mm, moderate pain at 45-74 mm, and severe pain at 75-100 mm. | — |
Secondary
| Measure | Time frame |
|---|---|
| Neck Proprioception, measured through a neck repositioning test to assess cervical joint position sense. Timepoint: Before intervention (baseline)10 days after baseline (midpoint)3 weeks after baseline. Method of measurement: Cervical proprioception: Using the joint position error testing method of Revel et al., cervical joint repositioning errors will be quantified in degrees to evaluate cervical proprioception. The participants will face a target on the wall that will be 90 cm away while they will sit erect in a chair with back support. The patient will position their feet flat on the floor, their hips and knees bent to about 90 degrees, and their chest will strap to the chair to avoid thoracic rotation throughout the examination. The target, a circle with a diameter of 40 cm, will be set up so that the center of the circle will line up with the laser pointer on the subject's forehead. Participants will first need to spend a few seconds learning a neutral position as part of the protocol. Then, participants will be instructed to turn their head to the left or right, and then slowly rotate their head to line up with the center of the circular target (neutral position) while covering their eyes with a blindfold. (O') indicates the center of the circle. Centimeters will measure the distance between the center of the circle and the patient's indicated point (OC). OD indicates the distance between the patient's eyes and the target. The measured centimeter distance between the circle's center and the light point will then be converted to degrees. Using the formula (a=tan^(-1)?(OC/OD)),.;Visual and Auditory Reaction Time and Anticipatory Skills, assessed using the Speed Anticipation Reaction Time (SART) system to evaluate neurocognitive aspects. Timepoint: Before intervention (baseline)10 days after baseline (midpoint)3 weeks after baseline. Method of measurement: Speed anticipation reaction time (SART): A color LCD will be connected to a laptop to display the SAR | — |
Countries
Iran (Islamic Republic of)
Contacts
Public Contactkarrar albomahmood
Tehran University of Medical Sciences
Outcome results
None listed