The efficacy of an integrated neuromuscular inhibition technique on upper trapezius trigger points in subjects with non-specific neck pain: a randomized controlled trial

Abstract

Currently, large levels of practice variability exist regarding the clinical deactivation of trigger points. Manual physical therapy has been identified as a potential means of resolving active trigger points; however, to date the ideal treatment approach has yet to be elucidated. The purpose of this clinical trial was to compare the effects of two manual treatment regimens on individuals with upper trapezius trigger points. Sixty patients, 19-38 years of age with non-specific neck pain and upper trapezius trigger points, were randomized into one of two, 4 week physical therapy programs. One group received muscle energy techniques while the second group received an integrated neuromuscular inhibition technique (INIT) consisting of muscle energy techniques, ischemic compression, and strain-counterstrain (SCS). Outcomes including a visual analog pain scale (VAS), the neck disability index (NDI), and lateral cervical flexion range of motion (ROM) were collected at baseline, 2 and 4 weeks after the initiation of therapy. Results revealed large pre-post-effect sizes within the INIT group (Cohen's d 5 0.97, 0.94 and 0.97). Additionally, significantly greater improvements in pain and neck disability and lateral cervical flexion ROM were detected in favor of the INIT group (0.29-0.57, 0.57-1.12 and 0.29-0.57) at a 95% CI respectively. The findings of this study indicate the potential benefit of an integrated approach in deactivating upper trapezius trigger points. Further research should be performed to investigate the long-term benefits of the current treatment approach.

Short-Term Changes in Neck Pain, Widespread Pressure Pain Sensitivity, and Cervical Range of Motion After the Application of Trigger Point Dry Needling in Patients With Acute Mechanical Neck Pain: A Randomized Clinical Trial

“…35,46 TrP dry needling (TrPDN) is one proposed treatment method 15 that has been shown to reduce TrP-associated pain. 38,43 A recent meta-analysis concluded that there is grade A (high-level) evidence to support the use of TrPDN in patients with upperquarter myofascial pain, particularly chronic neck and shoulder pain.…”

The effect of the combination of dry needling and MET on latent trigger point upper trapezius in females

“…This in turn leads to sympatho-excitation and activation of the periaqueductal gray matter, which plays a role in the M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT descending modulation of pain. Owing to stimulation of the mechanoreceptors, simultaneous gating of the nociceptive impulses takes place in the dorsal horn of the spinal cord (27).…”

Myofascial Trigger Points, Pain, Disability, and Sleep Quality in Individuals With Mechanical Neck Pain

“…In addition, there is some evidence demonstrating that treatment of active MTrPs is effective for reducing symptoms in patients with mechanical neck pain. [10][11][12] These studies suggest that MTrPs can be involved in the genesis of mechanical neck pain.…”