Dry Needling Dosage in the Treatment of Myofascial Neck Pain

Study Overview
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Brief Summary
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The purpose of this study are (1) to determine the effectiveness of different dry needling dosages in the treatment of myofascial trigger points in the upper trapezius muscle in patients with myofascial neck pain, (2) to assess postneedling soreness and tenderness and (3) evaluate the influence of psychological factors on the perception of postneedling soreness.

Official Title
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Effects of Different Deep Dry Needling Dosages on Pain and Postneedling Soreness in the Treatment of Patients With Cervical Myofascial Pain

Conditions
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Neck Pain

Intervention / Treatment
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* Procedure: Dry needling
* Procedure: Control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of an active myofascial trigger point. Neck pain: Superior to 3 cm in VAS Exclusion Criteria: Neck area: Fracture, radiculopathy, previous surgery, previous needling treatment in the last 6 months, previous analgesic medication (24 hours), psychiatric disease

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 53 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
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Dry needling: 4 local twitch responses<br>Deep dry needling in the active myofascial trigger point in the upper trapezius muscle. The muscle fibers were repeatedly perforated by rapidly inserting and partially withdrawing the needle from the MTrP until 4 local twitch responses were elicited. | Procedure: Dry needling<br> <br> |
| Experimental: Dry needling: 6 local twitch responses<br>Deep dry needling in the active myofascial trigger point in the upper trapezius muscle. The muscle fibers were repeatedly perforated by rapidly inserting and partially withdrawing the needle from the MTrP until 6 local twitch responses were elicited. | Procedure: Dry needling<br> <br> |
| Experimental: Dry needling: Until no more local twitch responses elicited<br>Deep dry needling in the active myofascial trigger point in the upper trapezius muscle. The muscle fibers were repeatedly perforated by rapidly inserting and partially withdrawing the needle from the MTrP until no more local twitch responses were elicited. | Procedure: Dry needling<br> <br> |
| Active Comparator: Control<br>The needle was inserted 1.5 cm away from the trigger point in the trapezius muscle and withdrawn without any consecutive insertion. | Procedure: Control<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain | Visual analog scale. A 100mm VAS, ranging from 0mm (no pain) to 100mm (worst imaginable pain). | 1 week | 
| Postneedling soreness | Visual analog scale. A 100mm VAS, ranging from 0mm (no pain) to 100mm (worst imaginable pain). | 1 week | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pressure pain threshold | Three consecutive trials of pressure pain threshold on the active trigger point at a rate of 1 kg/sec at intervals of 30 seconds were conducted. | 1 week | 
| Cervical range of motion | The subjects sat in a chair and a CROM goniometer was placed over the head. They were asked to perform active neck movements to the fullest extent of their mobility. Each movement was recorded three times and the average value was calculated. | 1 week | 
| Neck disability | Neck Disability Index questionnarie was completed. | 1 week | 
| Pain in cervical range of motion | Pain in a numerical pain rating scale during all cervical movements was recorded. | 1 week | 
| Psychological factors | State Trait Anxiety Inventory (STAI-T) | Pre-intervention | 
| Psychological factors | Beck Depression Inventory (BDI-II) | Pre-intervention | 
| Psychological factors | Tampa Scale for Kinesiophobia | Pre-intervention | 
| Psychological factors | Pain Catastrophizing Scale | Pre-intervention |