Dry Needling Versus Graston Technique in Active Myofascial Trigger Points on Upper Trapezius

Not Applicable

Completed

Brief Summary: This study will compare the effects dry needling and Graston technique in active myofascial trigger points on upper trapezius. Half of the study participants will receive dry needling whereas other half will receive Graston technique.

Detailed Description: This is a single blinded randomized controlled trial, will be conducted at Rawal General \& Dental Hospital, Islamabad. Both dry needling and Graston Techniques are used to release active Myofascial Trigger points with different mechanism.

Dry needling is technique in which without any medication or injection, dry needles are inserted into hyper irritable points in muscle. Graston technique is done with specially designed tools to locate knots within muscle by running the tools over the skin.

This study is planned with objectives to compare both treatment techniques on active myofascial trigger points in patients with neck pain. Effects of these will be measured on Neck Pain, Range of Motion, functional status and trigger points.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Patients that were using any medication to reduce the pain and/or have any effect in the skeleton muscle.
Patient taking other treatment in the same period of research.
Patients having malignancy, tuberculosis, spinal cord injury, neurodegenerative diseases radiculopathies and hematoma.
Patients on anticoagulants.
Patient with chronic neck pain.

Arm && Interventions

Group	Intervention	Description
Dry needling	Dry Needling Group	Dry needling will be applied on active myofascial trigger points in upper trapezius along with conservative physical therapy management.
Graston	Graston Technique Group	Graston Technique will be applied on active myofascial trigger points in upper trapezius along with conservative physical therapy management.

Primary Outcome Measures

Name	Time	Method
Numeric Pain Rating Scale (NPRS)	Post 2nd week	Numeric Pain Rating Scale (NPRS) is used to assess pain. It scores ranges from 0-10, 0 means No pain and 10 means Severe pain. Patient will be asked to verbally report the pain score.
cervical range of motion (CROM)	Post 2nd week	A cervical range of motion (CROM) inclinometer will be use to assess cervical range of motion in flexion, extension, left right lateral flexion and left-right rotation. Participants will be seated upright and asked to actively move their neck in each direction.
Myofascial Diagnostic Scale (MDS)	Post 2nd Week	It is a scale using the signs of a Myofascial trigger point as indicators to assess the extent to which the patient suffers from Myofascial Pain Syndrome. The signs include: referred pain in the zone of reference, local twitch response, palpable taut band, and focal or spot tenderness. Spot tenderness or soft tissue tenderness consisted of five grades or indicators: grade 0 - no tenderness = 0, grade 1 - tenderness to palpation without grimace or flinch = 1, grade 2 - tenderness with grimace and/or flinch to palpation = 2, grade 3 - tenderness with withdrawal = 3, grade 4 - withdrawal to non-noxious stimuli = 4. The presence of a local twitch response and the presence of a palpable taut band were indicated by a score of 4 on the scale. The presence of referred pain was indicated by a score of 5. A total score of 9 or more was indicative of active trigger points.

Secondary Outcome Measures

Name	Time	Method
Neck Disability Index (NDI)	Post 2nd week	Neck Disability Index (NDI) is a questionnaire designed to assess how neck pain has affected patient's ability to manage in everyday life. It has total 10 sections, For each section the total possible score is 5: if the first statement is marked the section score = 0, if the last statement is marked it = 5. If all ten sections are completed the score is calculated and converted into percentages. The maximum Score of Neck Disability Index (NDI) is 50.