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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

NCT07601880 — Not applicable, Completed, 40 participants, Lahore University of Biological and Applied Sciences

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

RegistryNCT07601880, acronym DNPP MTrP
StatusCompleted
PhaseNot applicable
Study typeInterventional; randomized, parallel, masking: single, treatment
Enrollment40 (Actual)
SponsorLahore University of Biological and Applied Sciences (Other)
ConditionsTrigger Points, Myofascial, Cervical Postural Deviation
InterventionsDry Needling + Phonophoresis, Dry Needling (Other)
Datesstart 2026-01-25, primary completion 2026-05-15, completion 2026-05-15, first posted 2026-05-22, last updated 2026-06-18
Locations1 site in Pakistan

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-Summary

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

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+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.

+Arms and interventions

ArmTypeInterventionsDescription
Group 1ExperimentalOther: Dry NeedlingReal Dry needling + sham phonophoresis
Group 2ExperimentalOther: Dry Needling + PhonophoresisSham dry needling + real phonophoresis
  • Dry Needling + Phonophoresis (Other), also known as Phonophoresis, dexamethasone: * 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
  • Dry Needling (Other): •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

+Outcome measures

Primary outcomes

  • Range Of motion [4 weeks]: Cervical Range of motion. These ranges are taken by Goniometer.
  • Numeric Pain Rating Scale [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

+Eligibility

Sex: All, ages: 20 Years to 70 Years

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

+Locations (1)

FacilityCityCountryStatus
Ghurki Trust Teaching HospitalLahore, Punjab ProvincePakistan

+Publications

  • Abbaszadeh-Amirdehi M, Ansari NN, Naghdi S, Olyaei G, Nourbakhsh MR. Therapeutic effects of dry needling in patients with upper trapezius myofascial trigger points. Acupunct Med. 2017 Apr;35(2):85-92. doi: 10.1136/acupmed-2016-011082. Epub 2016 Oct 3. PMID 27697768

+Investigators

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