Analyzing Positional Release Therapy and Dry Needling

August 29, 2026 updated by: Iram Iqbal Shamsi, University of Karachi

Analyzing Positional Release Therapy and Dry Needling to Improve Pain and Function in Levator Scapulae Syndrome

Levator scapulae syndrome (LSS) is a common musculoskeletal disorder that affects people in a variety of vocations, especially those that require extended static postures and repetitive motions. It is frequently characterized by persistent neck and shoulder pain. Among them, cosmetics professionals Desk top professional and are particularly vulnerable because of the nature of their employment, which involves tasks like prolonged, uncomfortable postures that lead to muscular imbalance.along them Levator Scapulae Syndrome (LSS) is quite common in manual laborers because of heavy lifting, overhead reaching, and repetitive lifting. This results in significant discomfort, stiffness, and limited neck movement due to persistent muscular tension, decreased flexibility, and trigger points in the neck and upper back.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Following the screening, participants will be randomized to receive the experimental or the controlled treatment in a1:1 ratio. Computer-generated random numbers will be used for Randomization. After obtaining the basic information, a unique code will be provided to each included patient. The outcome assessor will be blinded to the type of treatment. Patients and investigator could not be blinded due to the nature of treatment. Group "A "(experimental group) will receive Positional Release Technique on Levator Scapulae (Both if Necessary) Group "B" (control group) will receive (control group) will receive Dry needling treatment ,along with Neck strengthening exercises.

All patients will be Assessed for Pain , ROM and Functional Activities at base line and after 4 weeks.

Visual Analogue Scale(VAS) and CROM will be used for pain and ROM respectively.Neck Disability Index (NDI), Oxford Scale, ) will be used for Muscle strength and Daily life disaility Global Rating for patient's assessment of their own progress or decline during a particular course of treatment. and finaly EuroQol-5D (EQ-5D) to evaluate health-related quality of life. Mobility, self-care, routine activities, pain/discomfort, and anxiety/depression are the five main variables that are assessed.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
102

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Pakistan
    • Sindh
      • Karachi, Sindh, Pakistan, 74200
        • Recruiting
        • Sind Institute of Physical Medicine & Rehabilitation
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

18-40 years Willing to participate Having Positive Levator scapulae Test -

Exclusion Criteria:

Any history related to spinal surgery, Previous administration of epidural injections. Neck pain due to specific pathology, Neurological deficits (Myelopathy) and Clinical disorder contraindicated to exercise

-

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Positional Release Technique PRT

Group "A"(experimental group) will receive Positional Release Technique on Levator scapulae (may be both if necessary).along with Neck strengthening exercises.

Patient will be in supine lying with the elbows to the side of the upper body therapist sitting behind stabilizing superior border of scapula, with other hand holding the occiput region. Palpating tender points around superior-medial border of scapula and with occipital hand move the head and neck towards painful side. Pressure will be applied to a Pain perception of 10 and than Physiotherapis MOve the Neck in Different combilation of Movemnt Like Flexion , Side bending Rotation or Extension untill Patient start to feel a minimum releif of Tender point of 75 %. three sets on each side with 30 seconds hold on tender point. A rest of 15 seconds will be given between all sets. Following exercises will be given Rowing, horizontal abduction, shrug, horizontal abduction with ER, prone shoulder extension
Other: Positional release Technique
This Techniques Introduce in 1980 by DO Jones. By name of Spontaneous Release than Strain Counterstrain but Now Term PRT is Used Gobally. Muscle rlaxation is Achieved by Putting the muscle in Mos comfortable postion
Other: Dry Needling
Despite using the same type of filiform (solid) needles, it is not the same as acupuncture. While acupuncture regulates the body's energy flow through conventional channels, dry needling is a Western medical treatment used specifically to relieve pain and release tight muscle knots.
Active Comparator: Active Comparator: Dry Needling Therapy

Group "B" (control group) will receive Dry needling treatment consisting along with Neck strengthening exercises.

Patient will be in prone lying with the elbows adducted the upper body weight rests on the elbows, for further enhancement patient flexes the neck and lets the shoulder girdle relax. A pillow will be placed under shoulder to protrude scapula, exposing the super medial border for palpation and Introducing needles from a superior to inferio posterior angle to avoid lung lobe. With therapist wearing glove Alcohol swaps will be used to clean the area to be treated, A 30-40mm (0.32-0.35 gauge) needle will be used depending on body size.

Following exercises will be given Rowing, horizontal abduction, shrug, horizontal abduction with ER, prone shoulder extension
Other: Positional release Technique
This Techniques Introduce in 1980 by DO Jones. By name of Spontaneous Release than Strain Counterstrain but Now Term PRT is Used Gobally. Muscle rlaxation is Achieved by Putting the muscle in Mos comfortable postion
Other: Dry Needling
Despite using the same type of filiform (solid) needles, it is not the same as acupuncture. While acupuncture regulates the body's energy flow through conventional channels, dry needling is a Western medical treatment used specifically to relieve pain and release tight muscle knots.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
VAS Visual Analogue Scale VAS Visual Analogue Scale
Time Frame: Baseline and After Four weeks of Treatment
The visual analogue scale is used for measurement of pain intensity. It is a continuous scale. It comprises a horizontal/vertical 10 centimeters or 100 millimeters line. The higher scores shows higher pain intensity and lower scores shows lower pain intensity.Left Anchor (0 cm): Represents "No pain" and The Right Anchor (100 cm): Represents "Worst possible pain". Increase in cm indicate worsening of the pain.
Baseline and After Four weeks of Treatment
The Oxford Muscle Scale
Time Frame: Baseline and After Four weeks of Treatment
The Oxford muscular Scale, sometimes called the Medical Research Council or MRC scale, as a standardized instrument to measure muscular strength and power, Evaluate and grade manual muscle strength and power on a standardized scale from 0 to 5. Where 0 Means No contraction (lowest) and grade 5 (highest) muscle exhibits normal strength and can move through a full range of motion against maximal, firm resistance. Increase in Grades represent Improving in Strength and recovery while decrease in grade shows weakness and decline in strength.
Baseline and After Four weeks of Treatment
Cervical Range of Motion (CROM) Universal Goniometery
Time Frame: Baseline and After Four weeks of Treatment
The cervical spine's (neck's) functional mobility is determined using the Cervical Range of Motion (CROM) test. It determines how far a person can move their head in various directions, to assist diagnose neck discomfort, evaluate the healing process following an accident, and monitor the course of rehabilitation.Cervical goniometry is the clinical method of measuring neck mobility using a standard handheld universal goniometer. The goniometer's stationary arm always tracks a fixed reference line relative to the ground or torso. The moving arm follows the structural movement of the skull. Measures CROM in degrees. Increase in degrees denote improvement and increase ROM
Baseline and After Four weeks of Treatment
EuroQol-5D (EQ-5D)
Time Frame: Baseline and After Four weeks of Treatment
Measure generic health-related quality of life (HRQoL). It is one of the most widely used Patient-Reported Outcome Measures (PROMs) globally. The EQ-5D descriptive system is a preference-based HRQL measure with one question for each of the five dimensions that include mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The EQ-5D questionnaire also includes a Visual Analog Scale (VAS), by which respondents can report their perceived health status with a grade ranging from 0 (the worst possible health status) to 100 (the best possible health status).
Baseline and After Four weeks of Treatment

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Neck Disability Index (NDI)
Time Frame: Baseline and After Four weeks of Treatment
The gold-standard Client reported questionnaire to measure how much neck discomfort interferes with day-to-day functioning is the Neck Disability Index (NDI).Measure how much neck pain affects a patient's daily activities and to track their progress over time. It consists of 10 sections covering areas like pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleeping, and recreation. Each section is scored from 0 (no disability) to 5 (severe disability), giving a total possible raw score of 50. Scores of 0-4 means No disability, Neck pain has negligible impact on daily living where scores of 25 - 34 reflects complete disability, Patient is bedbound or severely incapacitated by pain.
Baseline and After Four weeks of Treatment
Global Rating of Change (GRC)
Time Frame: Baseline and After Four weeks of Treatment
A simple, self-filled questionnaire used to gauge a patient's perceived progress or decline over time. It enables patients to list the extent to which their condition has improved since beginning an intervention. A single-item outcome measure used in clinical practice and research to quantify a patient's self-perceived improvement or deterioration over a specific period. The most heavily validated and widely used version is the 15-point scale (ranging from -7 to +7. Positive Scores (+1 to +7): Indicate improvement, where +1 represents "a tiny bit better" and +7 represents "a very great deal better", Neutral Score (0): Indicates the condition is unchanged or exactly "the same". Negative Scores (-1 to -7): Indicate worsening, where -1 represents "a tiny bit worse" and -7 represents "a very great deal worse". Scores of +4 or +5 and above indicate a definitive, highly successful clinical outcome.
Baseline and After Four weeks of Treatment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
University of Karachi

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
September 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
September 2, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
September 2, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
August 16, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 16, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
August 20, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
September 1, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 29, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
August 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • IIShamsi

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Due to ethical obligations, inadequate infrastructure, and the need to preserve scientific control.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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