Myofascial Pain Syndrome - Neck, Neck Pain, Trigger Point Pain
Conditions
Keywords
Dry needling, Electrical dry needling, neck pain, myofascial trigger point, kinesiophobia, psychological distress
Brief summary
Neck pain caused by myofascial trigger points (MTrPs) is common and is associated with pain, psychological distress, and kinesiophobia (fear of movement). This randomized clinical trial compared Dry Needling (DN) and Electrical Dry Needling (EDN), each delivered once weekly for six weeks, in adults with neck pain due to MTrPs. The study measured changes in pain intensity, psychological distress (depression, anxiety, stress), and kinesiophobia before and after treatment, to determine whether adding electrical stimulation to dry needling provides additional benefit over dry needling alone.
Detailed description
This randomized clinical trial was conducted at Madinah Teaching Hospital, Health 360, and Holistic Medical Care in Faisalabad. A total of 75 participants were screened; 34 met the inclusion criteria (adults aged 18-60 years with neck pain of at least 3 weeks' duration, at least one active myofascial trigger point in the upper trapezius, levator scapulae, sternocleidomastoid, splenius capitis, or scalenes, and pain intensity of at least 4 on the Numeric Pain Rating Scale) and were randomized into two equal groups using simple random sampling. Group A (n=17) received Dry Needling and Group B (n=17) received Electrical Dry Needling, one session per week for six weeks. Dry Needling used the Hong fast-in/fast-out technique to elicit local twitch responses followed by ischemic compression. Electrical Dry Needling involved needle insertion into the trigger point/taut band followed by low-frequency (2 Hz) continuous biphasic electrical current applied for 30 minutes. Outcomes were assessed at baseline and after 6 weeks using the Numeric Pain Rating Scale (NPRS), the Depression Anxiety and Stress Scale (DASS-21), and the Tampa Scale for Kinesiophobia (TSK-11). One participant dropped out of each group, leaving 32 participants (16 per group) in the final analysis. Data were analyzed using SPSS version 20 with parametric (paired and independent samples t-tests) and nonparametric (Wilcoxon Signed-Rank, Mann-Whitney U) tests as appropriate.
Interventions
PROCEDUREDry Needling
Stainless-steel acupuncture needles inserted via guide tubes using the Hong technique (rapid insertion/withdrawal in multiple directions) to elicit up to 5 local twitch responses at the active myofascial trigger point, followed by ischemic (Travell and Simons) compression until pain decreased, repeated over several cycles for a total of 2 minutes. One session weekly for 6 weeks.
PROCEDUREElectrical Dry Needling
Needle inserted (after cleaning with sterile alcohol) into the diagnosed active or latent myofascial trigger point/taut band, manipulated bidirectionally to elicit pain/tingling/pressure/heaviness/warmth, then connected to a low-frequency (2 Hz) continuous biphasic electrical current at a mild-to-moderate intensity, left in place for 30 minutes. One session weekly for 6 weeks.
Sponsors
University of Faisalabad
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Adults aged 18-60 years of either gender. * Neck pain duration ≥ 3 weeks. * Presence of at least one active myofascial trigger point in the upper trapezius, levator scapulae, SCM, splenius capitis, or scalenes, confirmed using Travell and Simons' criteria. * Pain intensity ≥ 4 on NPRS (0-10) at baseline. * Ability to understand and complete questionnaires. * Willingness to participate and provide written informed consent.
Exclusion criteria
* History of cervical spine trauma, fracture, or surgery. * Diagnosis of neurological deficits. * Systemic diseases affecting muscles or joints. * Use of anticoagulant therapy or bleeding disorders. * Pregnancy or lactation. * Active infection or skin lesions in the cervical region. * Previous dry needling or electrical dry needling treatment in the past 6 months. * Allergy to needles or local anesthetics if used.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain Intensity | Baseline (pre-treatment) and Week 6 (post-treatment) | Measured using the Numeric Pain Rating Scale (NPRS), an 11-point scale where 0 = "no pain" and 10 = "worst pain imaginable". |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Psychological Distress | Baseline (pre-treatment) and Week 6 (post-treatment) | Measured using the Depression, Anxiety and Stress Scale (DASS-21), covering depression, anxiety, and stress subscales. |
| Kinesiophobia | Baseline (pre-treatment) and Week 6 (post-treatment) | Measured using the Tampa Scale for Kinesiophobia (TSK-11), an 11-item scale assessing fear of movement/re-injury. |
Countries
Pakistan
Contacts
STUDY_CHAIRDr Muhammad Ateeb, PhD Public Health
The University Of Faisalabad
Outcome results
None listed