Dry Needling and Electromyographic Changes in Neck Pain

Study Overview
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Brief Summary
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There is evidence suggesting that patients with mechanical neck pain exhibit higher activity of the superficial neck flexor muscles during the execution of the cranio-cervical flexion test. In addition, some studies have reported the presence of active trigger points in the neck flexor and extensor muscles. Since preliminary evidence suggests that trigger points can affect motor control behaviour, it is possible that management of these trigger points with dry needling could be effective for improving muscle activity during low-load activities, such as the cranio-cervical flexion test. Therefore, the aim of this study will be to investigate the effects on electromyographical activity, pressure pain thresholds and cervical range of motion after the application of dry needling over active TrPs in the upper trapezius muscle in patients with mechanical neck pain.

Official Title
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Electromyographic Changes in the Cranio-Cervical Flexion Test After Dry Needling of the Upper Trapezius Muscle in Patients With Mechanical Neck Pain

Conditions
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Neck Pain

Intervention / Treatment
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* Other: Dry Needling
* Other: Manual Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Generalized neck-shoulder pain with symptoms provoked by neck postures, neck movement, or palpation of the cervical musculature. Exclusion Criteria: whiplash injury; previous cervical or thoracic surgery; cervical radiculopathy or myelopathy; diagnosis of fibromyalgia syndrome; having undergone physical therapy in the previous 6 months; less than 18 or greater than 55 years of age fear to needles

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 55 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<br>Patients will receive dry needling over active trigger points in the upper trapezius muscle | Other: Dry Needling<br>* Patients will receive dry needling over active trigger points in the upper trapezius muscle<br>|
| Active Comparator: Manual Therapy<br>Patients will receive a manual compression for 30seconds over active trigger points in the upper trapezius muscle | Other: Manual Therapy<br>* Patients will receive a manual compression for 30seconds over active trigger points in the upper trapezius muscle<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in electromyographic activity of the neck superficial flexor muscles before and after the intervention | Bipolar surface EMG will be recorded with pairs of electrodes positioned 20mm apart and fixed firmly with an adhesive tape bilaterally over the sternocleidomastoid, the anterior scalene, the upper trapezius and the splenius capitis muscles. | Baseline and 5 minutes after treatment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in neck pain intensity with a numerical pain rate scale before and after the intervention | A Numerical Pain Rate Scale (NPRS, 0-10) will be used to assess spontaneous neck pain intensity | Baseline and 5 minutes after treatment | 
| Changes in widespread pressure pain sensitivity before and after the intervention | Pressure pain thresholds will be assessed over C5/C6 zygapophyseal joints, second metacarpal, and tibialis anterior muscle | Baseline and 5 minutes after treatment | 
| Changes in cervical range of motion before and after the intervention | Active cervical range of motion will be assessed with a Cervical Range of Motion (CROM) device in all cervical motions | Baseline and 5 minutes after treatment | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Neck Pain, Trigger points, Dry needling, Cranio-cervical flexion test