Dry Needling Versus Strain-counterstrain on the Upper Trapezius

Study Overview
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Brief Summary
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This study investigates the effect of two different techniques (dry needling and Strain-counterstrain manual technique) on the upper trapezius myofascial trigger point (MTP). Subjects with active or latent MTP in this location of the muscle will be identified and will be randomly assigned to one out of three groups: dry needling, strain-counterstrain or placebo manual technique. Pain pressure threshold, provoked pain, pain at rest, neck disability and electromyography (EMG) activity of the upper trapezius will be registered before and after six sessions of treatment.

Official Title
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Dry Needling Versus Strain Counterstrain Technique: Pilot Study Comparing Effects Over the Upper Trapezius Myofascial Trigger Point

Conditions
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Neck Pain

Intervention / Treatment
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* Other: Dry needling
* Other: Strain-counterstrain technique
* Other: Placebo manual technique


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Active myofascial trigger point at the upper trapezius Exclusion Criteria: Diagnosed fibromyalgia Cervical radiculopathy Facial neuralgia Coagulation alteration Cancer Allergy (included needles) History of cervical or shoulder surgery History of deep venous thrombosis History of myopathy History of infiltration at upper trapezius trigger point Anticoagulant medication Aspirin intake during the last 3 days Drug intake (AINES, narcotics, antiepileptics, or any other analgesic medication) Pregnancy

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Dry Needling of trigger point<br>Deep dry needling will be applied on the upper trapezius myofascial trigger point | Other: Dry needling<br>* Deep dry needling until achieving twitch response of the muscle<br>|
| Experimental: Strain-counterstraing technique<br>This manual technique will be applied at the upper trapezius. | Other: Strain-counterstrain technique<br>* A manual technique to release tension of painful muscles.<br>|
| Placebo Comparator: Placebo manual technique<br>A technique simulating strain-counterstrain, but without any therapeutic manoeuvre will be applied at the upper trapezius site. | Other: Placebo manual technique<br>* A placebo technique, consisting of manual contact of the therapist with the patient without any further therapeutic approach<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain Pressure Threshold | Amount of pressure (Kg/cm2) applied at the myofascial trigger point site that elicit pain for the patient will be reported. Analogy pressure algometer(Wagner, FPK 20) will be used. | 6 sessions | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain at rest | Visual Analogue Scale | 6 sessions | 
| Neck Disability | Neck Disability Index | 6 sessions | 
| Electromyographic activity of the upper trapezius | Surface EMG will be recorded (MP 100 de BIOPAC Systems; Goleta, California, USA). Electrodes will be located to register activity of the Upper trapezius, according to Surface ElectroMyoGraphy for the Non-Invasive Assessment of Muscles (SENIAM) guidelines. Microvolts of activity at rest will be recorded. Data will be normalized through calculation of maximal voluntary contraction, so that final data will be reported as a percentage. | 6 sessions |