Immediate Stiffness Changes in Myofascial Trigger Points After Dry Needling

Study Overview
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Brief Summary
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Shear-wave elastography (SWE) is considered as a useful tool for quantifying muscle stiffness. Considering that Myofascial Trigger Points (MTrP) are defined as hyperirritable zones in contracted bands of muscle, thought to be caused by muscle overload or stress and the effectiveness of dry needling applied to active MTrP for reducing pain and disability, the aim of this study is to assess the effects of sham and real dry needling, applied to active MTrP in the upper trapezius muscle in patients with chronic neck pain, on the muscle stiffness in two areas: 1) the most symptomatic area and 2) a control point.

Official Title
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Immediate Stiffness Changes in Upper Trapezius Active Myofascial Trigger Points After Dry Needling in Patients With Neck Pain: A Randomized, Double-Blinded, Placebo-Controlled Trial

Conditions
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Myofascial Pain Syndrome, Neck Pain, Trigger Point Pain, Myofascial

Intervention / Treatment
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* Other: Dry Needling
* Other: Sham Dry Needling


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients between 18 and 65 and Presence of mechanical neck pain for at least three months duration Presence of at least one active MTrP in the Upper Trapezius muscle Exclusion Criteria: Neck pain of traumatic origin (such as whiplash-associated disorder) Current use of any kind of analgesic therapy Presenting any condition usually considered a perpetuating factor of MTrPs, such as fibromyalgia, hypothyroidism, or iron deficiencies Presenting any contraindication for Dry Needling application Neuropathies (e.g., radiculopathy) Bilateral Pain

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

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
Interventional Model Description: Randomized, Double-Blinded, Placebo-Controlled Trial
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Dry Needling<br>Dry needling will be performed with 'solid filiform needles'. The procedure is as follows: The participant will lie in the prone position. The overlying skin will be cleaned with antiseptic spray. The taut band and MTrP, will be localized manually. After measuring the Pain Pressure Thresholds in this location and the control (located 3 cm lateral to the MTrP), the needle within its plastic guide tube will be placed over the MTrP. After a tapping movement to insert the needle, the needle will be moved to the muscle around the bundle and moved forward and backward to the tissue to elicit a small muscle twitch. After eliciting LTR, needling will be stopped. If no twitch were elicited, needling will stopped after two or three stellate movements | Other: Dry Needling<br>* Real Dry Needling in the most active Myofascial Trigger Point<br>|
| Sham Comparator: Sham Dry Needling<br>The same approach will be used with the exception of piercing the skin. The guide tube will press against the tissue and the sham needle will be allowed to drop against the skin. The handle will be tapped briskly but not breaking the skin. The sham needle will stay within the guide tube and will be pressed against the skin twice so as to mimic the quick in and out technique. | Other: Sham Dry Needling<br>* Sham Dry Needling in the same location, but not piercing the skin<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| SWE - Young modulus | KPa | Baseline | 
| SWE - Young modulus | KPa | 10 minutes | 
| SWE - Local shear wave speed | m/s | Baseline | 
| SWE - Local shear wave speed | m/s | 10 minutes | 
| Pain Pressure Thresholds | kg/cm2 | Baseline | 
| Pain Pressure Thresholds | kg/cm2 | 10 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual Analogue Scale | 0-10 | Baseline | 
| Neck Disability Index | 0-100 | Baseline |