the Study Aim to Evaluate the Combined Therapeutic Effects of Dry Needling and Phonophoresis on Myofascial Trigger Points in Patient Suffering From Cervical Spine Postural Deviations. it Focuses on How These Interventions Help Reduce Pain, Relieve Muscle Spasm and Improve Functional Outcomes. (DNPP-MTrP-CSP)

May 15, 2026 updated by: Umber Nawaz, Lahore University of Biological and Applied Sciences

Effects of Dry Needling and Phonophoresis on Myofascial Trigger Points Among Patient With Postural Deviation of Cervical Spine.

Postural deviations of the cervical spine, particularly forward head posture (FHP) and altered cervical lordosis, are increasingly common in individuals with prolonged use of computers, mobile phones, and poor sitting posture. These deviations lead to muscular imbalances where weak deep cervical stabilizers coexist with tight, overactive muscles such as the upper trapezius and sternocleidomastoid. The biomechanical consequences include excessive stress on cervical joints, impaired proprioception, reduced cervical range of motion, and a predisposition to chronic neck pain, cervicogenic headaches, and even temporomandibular disorders.

Myofascial trigger points (MTrPs) in the sternocleidomastoid and upper trapezius are frequently implicated in these conditions, contributing to pain, stiffness, and sensorimotor dysfunction. Trigger points are characterized by taut muscle bands, localized hypoxia, biochemical mediators of pain, and neuromuscular hyperexcitability. Treatments such as dry needling (DN) aim to mechanically disrupt this pain-spasm cycle by reducing motor end plate irritability and sympathetic overactivity, whereas phonophoresis (PH) enhances trans-dermal absorption of anti-inflammatory or analgesic drugs using ultrasound, providing a non-invasive alternative for pain management.

Given the high prevalence of cervical postural deviations and the burden of associated pain and disability, there is a need to identify the most effective intervention for MTrPs in this population. This study, therefore, proposes a randomized controlled trial comparing the effects of dry needling and phonophoresis on pain, cervical range of motion, and postural correction in patients with FHP and altered cervical lordosis. The findings aim to guide clinicians in selecting evidence-based treatments to optimize outcomes for patients with cervical spine abnormalities.

Study Design: Randomized Control Trial No of groups: 40 (men and women aged 20-55 year) 20 receiving phonophoresis and 20 receiving Dry Needling.

Outcomes:

  1. Reduction in Neck Pain
  2. Cervical Range of Motion

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This randomized controlled trial aims to compare the effectiveness of dry needling and phonophoresis in releasing myofascial trigger points among patients with cervical postural deviations. A total of 40 participants (men and women aged 20-55 years) with chronic neck pain and active trigger points in the upper trapezius and levator scapulae muscles will be recruited using non-probability purposive sampling. Participants will be randomly allocated into two groups (20 each) using a double-dummy, participant-blinded design: one group will receive real dry needling with sham phonophoresis, while the other will receive real phonophoresis with sham dry needling. Both groups will also receive baseline stretching exercises.

Phonophoresis will be applied using diclofenac sodium with pulsed ultrasound, while dry needling will involve insertion of a sterile needle to elicit a local twitch response. Outcomes will be assessed over a 4-week period, focusing on improvement in cervical range of motion, and reduction in neck pain. The study seeks to determine which intervention is more effective for managing myofascial trigger points associated with cervical postural dysfunction in patients with chronic neck pain.

Study Type

Interventional

Enrollment (Actual)

40

Phase

  • 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 Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 57000
        • Ghurki Trust Teaching Hospital

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

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Chronic Neck pain
  2. Trigger points in Trapezius and Levetor Scapulae
  3. Duration of Pain from at least 3 months

Exclusion Criteria:

  1. Person's History of Neck Surgery
  2. Local Hemmorhage
  3. Active infections and Open wounds
  4. Bleeding disorders
  5. use of alcohol or any material that disturbs the consciousness

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
Intervention / Treatment
Experimental: Group 1
Real Dry needling + sham phonophoresis
Procedure: Group 1
•0.25 × 40 millimeter sterilized needle, We will insert the steralized needle into subcutaneous tissue in a position perpendicular to muscle. The needle tip will be inserted into the muscle until a local twitch response is elicited. The same point will be needled for about 60 seconds by rapid inward and outward needle movements Baseline Treatment is stretching
Other Names:
  • Dry Needling
Experimental: Group 2
Sham dry needling + real phonophoresis
Radiation: Group 2
  • Diclofenac Sodium medication will be used with ultrasound.
  • Ultrasound waves with 1.2 w/cm intensity 60 percent duty cycle will be applied by a Pulsed 1 MHz ultrasound unit for 5 minutes on MTPs Baseline Treatment is stretching
Other Names:
  • dexamethasone
  • Phonophoresis

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Regain Range Of motion
Time Frame: 4 weeks
Cervical Range of motion. These ranges are taken by Goniometer.
4 weeks
Reduce Neck Pain.
Time Frame: 4 weeks
Reduction in neck pain and for its measurement we use Numeric pain rating scale.
4 weeks

Collaborators and Investigators

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

Sponsor

Lahore University of Biological and Applied Sciences

Investigators

  • Study Chair: Umber Nawaz, UBAS

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

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 (Actual)

January 25, 2026

Primary Completion (Actual)

May 15, 2026

Study Completion (Actual)

May 15, 2026

Study Registration Dates

First Submitted

May 15, 2026

First Submitted That Met QC Criteria

May 15, 2026

First Posted (Actual)

May 22, 2026

Study Record Updates

Last Update Posted (Actual)

May 22, 2026

Last Update Submitted That Met QC Criteria

May 15, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • DPT/ERB/28
  • U1111-1333-4312 (Registry Identifier: Mahham Ali)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

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.

Clinical Trials on Trigger Points, Myofascial

Clinical Trials on Group 1

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Croatia

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe