Effects of Electro Dry Needling Versus Dry Needling in Levator Scapulae Syndrome

Not Applicable

Completed

Brief Summary: Mechanical neck pain is posteriorly occurring non-specific pain that originates from the superior nuchal line and extends to the first thoracic vertebrae. It is exacerbated by sustained neck postures, neck movements or cervical muscle palpation. The aim of study will be to compare the effects of Electro Dry Needling and Dry Needling on pain, muscle strength, disability and range of motion in patients with Levator Scapulae Syndrome.

Detailed Description: A Randomized Clinical Trial will be conducted at Shalamar Hospital, (SIHS Physiotherapy Clinic Lahore) through convenience sampling technique on 30 patients which will be allocated using simple random sampling through sealed opaque enveloped into Group A and Group B. Group A will receive Electro Dry Needling along with conventional physiotherapy in which parameters for Electro dry needling will be needles of 30×0.25 mm, 50×0.25 mm sizes, Frequency 80-100 Hz, Duration 10-20 minutes and intensity as tolerated and Group B will receive Dry Needling along with conventional Physiotherapy in which parameters will be dry needles will be 30×0.25 and 50×0.25 mm sizes. Standard Physiotherapy will include a Hot pack (10 min), Stretching of levator scapulae (3 times with 30 second hold), and Scapular stabilization exercises (10 times with 5 second hold).There will be 3 sessions per week, Needling in both groups will be for performed 2 times per week for total 3rd week of treatment comprising of 6 sessions, 3rd session will comprise of standard physical therapy. Pre and Post treatment measures will be recorded.Outcome measures will be conducted through pain, \*muscle strength,\* disability and range of motion questionnaire. Data will be analyzed during \*SPSS software version 25.After assessing the normality of data by the Shapiro-Wilk test, it will be decided whether a parametric or non-parametric test will be used within a group or between two groups.

Recruitment & Eligibility

Inclusion Criteria

Age ranges of 18-45 years
Both genders, males and females
Positive Levator Scapular length Test (7)
Positive Simon's criteria for Levator scapulae
Neck pain -NPRS < 7 (8)
Neck and upper back pain for at least 3months.
Examination - Increased muscle tone and tenderness at neck and upper back
Reduced ROM-Side flexion and Rotation of neck
Non traumatic unilateral mechanical neck pain of three or more months of duration, presenting an latent MTrP in the levator scapulae muscle on the painful side

Exclusion Criteria

Neuropathies
Radiated pain towards the arm
Vertebral fractures
Traumatic neck injury
whiplash injury (9)
previous surgical procedures in the cervical spine
Previous cognitive and functional disorders
psychological disorders (mood and psychotic disorders such as schizophrenia, depression,and anxiety disorders),
Fibromyalgia

Arm && Interventions

Group	Intervention	Description
Group A: Electro Dry Needling	Electro Dry Needling	Group A: will receive Electro Dry Needling along with conventional physiotherapy. The parameters for Electro dry needling will be needles of 30×0.25 mm, 50×0.25 mm sizes, Frequency 80-100 Hz, Duration 10-20 minutes and intensity as tolerated.
Group B: Dry Needling	Dry Needling	Group B will receive Dry Needling along with conventional Physiotherapy in which parameters will be dry needles will be 30×0.25 and 50×0.25 mm sizes, Frequency 80-100 Hz, Duration 10-20 minutes and intensity as tolerated.

Primary Outcome Measures

Name	Time	Method
Neck Disability index (NDI)	upto 3 weeks	The results of this questionnaire have been utilized to evaluate the disability. It consists of 10 items: 7 linked to activities of daily living, 2 to pain, and 1 to concentration. From 0 to 5, each item received a score. Higher scores corresponded to more disability, and the total score was reported as a percentage.
Numeric pain rate scale (NPRS)	upto 3 weeks	The NPRS is a segmented numeric version in which a respondent selects a whole number (0-10 integers) that best reflects the intensity of his/her pain. The common format is a horizontal bar or line. the NPRS is anchored by terms describing pain severity extremes. The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable").
Universal Goniometer	upto 3 weeks	An instrument called a goniometer is used to measure a joint's range of motion. Physical therapists typically use a goniometer to measure a range of motion. At the initial evaluation, the therapist can determine the possible range of motion using a goniometer . Range of motion: Side flexion and Rotation of neck measured with Goniometer.

Secondary Outcome Measures

Name	Time	Method