Physiotherapy for upper trapezius trigger points

Comparison of muscle energy technique plus static stretching versus static stretching alone in office workers with upper trapezius trigger points

Status

Recruiting

Phases

Phase 3

Study type

Interventional

Source

IRCT

Registry ID

IRCT20251222068409N1

Enrollment

Registered

2026-01-14

Start date

2026-01-23

Completion date

Unknown

Last updated

2026-02-02

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Upper Trapezius Trigger Points. Other disorders of the musculoskeletal system and connective tissue

Interventions

Intervention 1: Intervention group: Participants receive muscle energy technique (MET) combined with static stretching for the upper trapezius muscle, delivered by a qualified physiotherapist accordin

Eligibility

Sex/Gender

All

Age

18 Years to 45 Years

Inclusion criteria

Inclusion criteria: - Adults 18–45 years, both sexes.- - Clinically confirmed active, unilateral myofascial trigger point in the upper trapezius (the most active and most tender point). - Currently employed in office/desk-based work (= 20 h/week for = 6 months), typically = 4–6 h/day of sitting or computer use. - Neck pain >3 based on Numerical Pain Rating Scale.

Exclusion criteria

Exclusion criteria: - Diagnosed fibromyalgia - Facial neuralgia - Coagulation alteration - Cancer - History of cervical or shoulder surgery - History of deep vein thrombosis - History of myopathy - History of infiltration at upper trapezius trigger point - Patients with simultaneous Trigger Points in other body regions.

Design outcomes

Primary

Measure	Time frame
Numeric pain rating scale. Timepoint: Primary outcome will be measured at baseline (before intervention), immediately after completion of the 2-week intervention period, and at one-week follow-up after the end of the intervention. Method of measurement: The Numeric Pain Rating Scale (NPRS) is a unidimensional tool used to assess pain intensity. Patients rate their pain on an 11-point scale ranging from 0 (“no pain”) to 10 (“worst imaginable pain”) by marking or drawing a tick on the number that best represents their current pain level. This scale is widely used in both clinical and research settings due to its simplicity, reliability, and validity. A change of 2 points or approximately 30% reduction is typically considered clinically significant.;Neck Proprioception–Joint Position Sense (JPS). Timepoint: Primary outcome will be measured at baseline (before intervention), immediately after completion of the 2-week intervention period, and at one-week follow-up after the end of the intervention. Method of measurement: Joint Position Sense was evaluated using the cervicocephalic relocation test. A laser pointer was securely attached to the center of the participant’s forehead, and the subject was seated exactly 90 cm away from a fixed target on the wall. With eyes closed, the participant actively moved the head into contralateral lateral flexion, then attempted to return to the neutral starting position. The discrepancy between the initial reference point and the returned point was measured in centimeters, representing the repositioning error and serving as an indicator of cervical proprioceptive accuracy (27, 36). Contralateral lateral flexion was selected because the upper trapezius is most involved in side-bending movements. Active trigger points in this muscle primarily impair proprioception when the muscle is placed under stretch. Thus, contralateral flexion provides the most sensitive and specific direction to detect joint position sense errors associated with up	—

Measure

Time frame

Numeric pain rating scale. Timepoint: Primary outcome will be measured at baseline (before intervention), immediately after completion of the 2-week intervention period, and at one-week follow-up after the end of the intervention. Method of measurement: The Numeric Pain Rating Scale (NPRS) is a unidimensional tool used to assess pain intensity. Patients rate their pain on an 11-point scale ranging from 0 (“no pain”) to 10 (“worst imaginable pain”) by marking or drawing a tick on the number that best represents their current pain level. This scale is widely used in both clinical and research settings due to its simplicity, reliability, and validity. A change of 2 points or approximately 30% reduction is typically considered clinically significant.;Neck Proprioception–Joint Position Sense (JPS). Timepoint: Primary outcome will be measured at baseline (before intervention), immediately after completion of the 2-week intervention period, and at one-week follow-up after the end of the intervention. Method of measurement: Joint Position Sense was evaluated using the cervicocephalic relocation test. A laser pointer was securely attached to the center of the participant’s forehead, and the subject was seated exactly 90 cm away from a fixed target on the wall. With eyes closed, the participant actively moved the head into contralateral lateral flexion, then attempted to return to the neutral starting position. The discrepancy between the initial reference point and the returned point was measured in centimeters, representing the repositioning error and serving as an indicator of cervical proprioceptive accuracy (27, 36). Contralateral lateral flexion was selected because the upper trapezius is most involved in side-bending movements. Active trigger points in this muscle primarily impair proprioception when the muscle is placed under stretch. Thus, contralateral flexion provides the most sensitive and specific direction to detect joint position sense errors associated with up

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Secondary

Measure	Time frame
Neck Active Range of Motion. Timepoint: Neck Active Range of Motion will be measured at baseline (before intervention), immediately after completion of the 2-week intervention period, and at one-week follow-up after the end of the intervention. Method of measurement: Active cervical range of motion (AROM) will be assessed for contralateral lateral flexion, flexion, and extension using a Universal goniometer. All measurements will follow the standardized protocol described by Farooq et al. (2016) Participants will be seated upright in a standardized position, with the trunk stabilized against the backrest of a wooden chair, hips and knees at 90°, feet flat on the floor, and arms folded across the chest to minimize thoracic compensation. The head will be positioned in neutral alignment before each measurement For contralateral lateral flexion, the axis of the goniometer will be placed over the spinous process of C7, the stationary arm aligned vertically along the thoracic spine (perpendicular to the floor), and the moving arm aligned with the midline of the head toward the external occipital protuberance. Participants will actively bend the neck away from the symptomatic upper trapezius side until their end range of motion. For flexion and extension, the axis of the goniometer will be placed over the external auditory meatus, the stationary arm aligned vertically (perpendicular to the ground), and the moving arm aligned with the base of the nares. Participants will actively flex or extend the cervical spine to their comfortable end range. Each participant will perform three trials for each direction. A brief familiarization will be provided before taking measurements, consistent with PJMS protocol. Scapular elevation, thoracic movement, or trunk lean will be avoided through verbal cues and standardized positioning. A rest interval of 10–15 seconds will be provided between trials to minimize fatigue. The mean value (in degrees) of the three trials will be used as the f	—

Measure

Time frame

Neck Active Range of Motion. Timepoint: Neck Active Range of Motion will be measured at baseline (before intervention), immediately after completion of the 2-week intervention period, and at one-week follow-up after the end of the intervention. Method of measurement: Active cervical range of motion (AROM) will be assessed for contralateral lateral flexion, flexion, and extension using a Universal goniometer. All measurements will follow the standardized protocol described by Farooq et al. (2016) Participants will be seated upright in a standardized position, with the trunk stabilized against the backrest of a wooden chair, hips and knees at 90°, feet flat on the floor, and arms folded across the chest to minimize thoracic compensation. The head will be positioned in neutral alignment before each measurement For contralateral lateral flexion, the axis of the goniometer will be placed over the spinous process of C7, the stationary arm aligned vertically along the thoracic spine (perpendicular to the floor), and the moving arm aligned with the midline of the head toward the external occipital protuberance. Participants will actively bend the neck away from the symptomatic upper trapezius side until their end range of motion. For flexion and extension, the axis of the goniometer will be placed over the external auditory meatus, the stationary arm aligned vertically (perpendicular to the ground), and the moving arm aligned with the base of the nares. Participants will actively flex or extend the cervical spine to their comfortable end range. Each participant will perform three trials for each direction. A brief familiarization will be provided before taking measurements, consistent with PJMS protocol. Scapular elevation, thoracic movement, or trunk lean will be avoided through verbal cues and standardized positioning. A rest interval of 10–15 seconds will be provided between trials to minimize fatigue. The mean value (in degrees) of the three trials will be used as the f

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Countries

Iraq

Contacts

Public Contactkadhim hashim saud

self funded

kazemhashem987@gmail.com+964 771 443 5044

Outcome results

None listed

Source: IRCT (via WHO ICTRP) · Data processed: Feb 7, 2026