Effectiveness of Tele-Rehabilitation in Managing Rhomboid Trigger Points in Patients With Myofascial Pain Syndrome

Rhomboid myofascial pain syndrome is a common yet often underreported musculoskeletal condition characterized by the presence of myofascial trigger points within the rhomboid muscles. These trigger points produce localized and referred pain, reduced range of motion, and functional limitations that can significantly affect daily activities. The condition is strongly associated with poor posture, prolonged sitting, and repetitive upper limb activities, particularly among individuals with sedentary lifestyles and high occupational demands. Evidence indicates a high prevalence of rhomboid trigger points, with many individuals experiencing moderate pain that interferes with their routine work and overall quality of life.

Biomechanically, sustained postural stress such as forward head posture and rounded shoulders increases the load on scapular stabilizing muscles, leading to muscle fatigue, microtrauma, and the development of trigger points. These changes contribute to altered scapular kinematics, muscle imbalance, and restricted movement. Self-myofascial release techniques have been shown to reduce pain sensitivity, improve circulation, and restore muscle function, making them an effective approach for managing myofascial pain.

Tele-rehabilitation has emerged as a practical and accessible method for delivering physiotherapy interventions remotely, allowing patients to perform guided exercises and self-myofascial release without the need for frequent in-person visits. This is particularly beneficial for individuals with busy schedules or limited access to healthcare services.

This randomized controlled trial aims to evaluate the effectiveness of tele-rehabilitation, incorporating self-myofascial release and exercise therapy, in reducing pain intensity, improving functional range of motion, and decreasing neck disability in patients with rhomboid trigger points associated with myofascial pain syndrome. The study also seeks to determine the feasibility of tele-rehabilitation as a convenient and sustainable alternative to conventional physiotherapy for managing rhomboid-related musculoskeletal pain.

Inclusion criteria

• Participants falling in this category would be recruited into the study.

• Age 18-35 years
• Both Genders: Male and Female
• Paitents experiencing Neck and upper back pain due to active trigger points.(16) According to Travell and Simons (1999)criteria, active myofascial trigger points (MTrPs) are identified.
• NPRS ≥4
• Presence of maximum one or more than one MTrPs in the Romboids muscle.
• Prolong sitting at least 6 hours per day.
• Access to a device with internet connection ( for tele rehabilitation group).

Exclusion criteria

• Participants falling in this category would be excluded from the study.

• Participants fall in this category would be excluded of the study.
• Patients currently taking analgesics (painkillers) or muscle relaxants.
• Any inflammatory pathology, neurological impairment, and cervical tumor.
• Other deformities such as scoliosis or torticollis.
• Spinal Injuries and any other co morbidity.
• Any surgery, trauma, fracture and fall.
• Pregnancy.
• Patient unwilling to comply follow up schedule.
• Patient involvement in another interventional study.