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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)

16. juni 2026 oppdatert av: 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

Studieoversikt

Detaljert beskrivelse

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.

Studietype

Intervensjonell

Registrering (Faktiske)

40

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

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

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Group 1
Real Dry needling + sham phonophoresis
•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
Eksperimentell: Group 2
Sham dry needling + real phonophoresis
  • 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
Andre navn:
  • deksametason
  • Fonoforese

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Range Of motion
Tidsramme: 4 weeks
Cervical Range of motion. These ranges are taken by Goniometer.
4 weeks
Numeric Pain Rating Scale
Tidsramme: 4 weeks
Reduction in neck pain and for its measurement we use Numeric pain rating scale. Scale is scored on 0-10 points. 0 means no pain and 10 means severe/ unbearable pain
4 weeks

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Etterforskere

  • Studiestol: Umber Nawaz, UBAS

Publikasjoner og nyttige lenker

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Hjelpsomme linker

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

25. januar 2026

Primær fullføring (Faktiske)

15. mai 2026

Studiet fullført (Faktiske)

15. mai 2026

Datoer for studieregistrering

Først innsendt

15. mai 2026

Først innsendt som oppfylte QC-kriteriene

15. mai 2026

Først lagt ut (Faktiske)

22. mai 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

18. juni 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

16. juni 2026

Sist bekreftet

1. januar 2026

Mer informasjon

Begreper knyttet til denne studien

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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