Dry Needling and Maitland Joint Mobilization Techniques in Patients With Myofacial Chronic Neck Pain

To distinguish which technique is most effective in pain reduction and range gain because in chronic cases there is involvement of fascia, muscles and joints due to prolonged stress on any of the component affecting the other. Hence, the study will help to design a treatment plan with more accurate intervention. After sample collection according to selection criteria treatment sessions will be given to both groups for 6 weeks. Data will be collected at baseline, then after 2 weeks, 4 weeks and at 8th week. Tools for data collection are Visual analogue scale, Neck Disability Index and Goniometer. For statistical analysis SPSS 22 will be used. Intra group difference will be calculated by repeated measurement ANOVA / Friedman test and inter group analysis will be done by Independent sample t test. Descriptive data will be expressed in terms of frequency and proportions.

Inclusion criteria

• Bilateral pain involving the upper trapezius and elevator muscle of the scapula;
• Duration of pain of at least 3 months;
• A pain intensity corresponding to at least 20 mm on a 100 mm visual analogue scale (VAS)
• Neck pain with symptoms provoked by either neck postures or neck movement;
• Pain localized at least in the cervical and occipital regions but not in the orofacial region;
• Neck disability index (NDI) greater than or equal to 15 points;
• Restricted cervical range of movements (flexion, extension, rotation, and sidebending); (i) Presence of bilateral MTrPs in upper trapezius and levator scapulae muscles

Exclusion criteria

• Any signs, symptoms, or history of the following diseases:
• Orofacial pain and temporo-mandibular disorders
• A history of traumatic injuries (e.g., contusion, fracture, and whiplash injury);
• Systemic diseases such as fibromyalgia, systemic erythematous lupus, and arthritis; (d) Neurologic disorders (e.g., trigeminal neuralgia or occipital neuralgia);
• Concomitant medical diagnosis of any primary headache (tension type or migraine);
• Unilateral neck pain;
• Cervical spine surgery;
• Clinical diagnosis of cervical radiculopathy or myelopathy;
• Needle phobia;
• History of previous physical therapy intervention for the cervical region in last 6 months.