Ischemic Compression Compared With Dry Needling
Condition: Neck Pain; Shoulder Pain
MeSH terms: Shoulder Pain; Neck Pain
Study type: Interventional

Summary: 
      A randomized controlled trial will be conducted to examine the effectiveness of DN versus IC
      on trigger points in the neck and shoulder region for reducing pain and improving
      functionality (primary outcome measures) and to investigate the effectiveness of DN versus IC
      for muscle strength, mobility and muscle tone (secondary outcome measures).
    

Detailed description: 
      Neck-shoulder pain is common in office workers and is characterized by pain and fatigue in
      this shoulder and neck region. Usually, the muscles around the neck and shoulder are involved
      in work-related neck-shoulder pain ( M. Trapezius, M. Levator Scapulae, M. Splenius Cervicis,
      M. Infraspinatus). Typically, sensitive spots are often present in the muscles, which are
      defined as trigger points.

      In the treatment of trigger points both dry needling (DN) technique and ischemic compression
      (IC) technique are often used, supported by increasing scientific evidence.

      In the dry needling (DN) technique a thin (acupuncture) needle punctures directly a trigger
      point with the aim to generate a "local twitch response". These are involuntary contractions
      of the muscle fibers that cause muscle relaxation and will recover the metabolism of the
      muscle. In the ischemic compression (IC) technique, pressure is applied slowly and
      progressively over the trigger point (upon the skin).

      A randomized controlled trial will be conducted to examine the effectiveness of DN versus IC
      on trigger points in the neck and shoulder region for reducing pain and improving
      functionality (primary outcome measures) and to investigate the effectiveness of DN versus IC
      for muscle strength, mobility and muscle tone (secondary outcome measures).

      To comply with these scientific objectives, 60 people will be recruited. The participants
      will be recruited within several business companies. The participants are people who perform
      at least 4 hours a day office work for at least one full year. All participants will get
      information and an informed consent with information about the study.

      The subjects will be randomly assigned into two groups: one group treatment with DN, another
      group treatment with IC.

      All participants are subjected to the baseline assessment. The baseline assessment includes
      the assessment of pain, functionality, muscle strength, mobility and muscle tone. Twelve
      triggerpoints (at a fixed location) will be localized and pain assessment of those trigger
      points will be performed. The four most painful trigger points (points at which they can
      tolerate the least pressure) will be determined. The treatment of both DN and IC will be
      performed on those 4 most painful trigger points and will last for four weeks in total (with
      a frequency of one treatment/week).

      Two follow-up assessments will take place. A first follow-up assessment is provided one week
      post-intervention (short-term effects), in which all the tests are performed again. A second
      follow-up assessment is done at 3 months post-intervention (long-term effects).
    

Intervention name(s): Dry Needling; Ischemic Compression
Intervention type(s): Other; Other
Intervention description(s): (experimental- physiotherapy intervention) - will be performed during 4 weeks (1 treatment/week) on the 4 most painful trigger points (determined/selected at the first session - see above). The same 4 trigger points will be treated during the 4 weeks. DN will be performed by locating the taut band and the trigger point. Once the trigger point is located, the overlying skin will be cleaned with alcohol. A certified and experienced therapist will penetrate the needle through the skin 10-15mm. into the TrP until the local twitch response will be obtained.; (experimental - physiotherapy intervention) will be performed during 4 weeks (1 treatment/week) on the 4 most painful trigger points (determined/selected at the first session - see above). IC will be performed by applying a pressure with a wooden stick on the 4 individually determined most painful trigger points. The duration of the pressure will be about 60s, (increase of pressure 10N/s) until the highest tolerable pressure will be reached and this pressure will be held even when the pain is decreasing during the intervention. The subject will always be treated by the same clinician.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment