• Pain Med · Sep 2022

    Randomized Controlled Trial

    Immediate Effects of Dry Needing or Manual Pressure Release of Upper Trapezius Trigger Points on Muscle Activity during the Cranio-Cervical Flexion Test in People with Chronic Neck Pain: A Randomized Clinical Trial.

    • Jorge Rodríguez-Jiménez, Ricardo Ortega-Santiago, Laura Bonilla-Barba, Deborah Falla, César Fernández-de-Las-Peñas, and Lidiane L Florencio.
    • Department of Physical Therapy, Occupational Therapy, Physical Medicine, and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain.
    • Pain Med. 2022 Sep 30; 23 (10): 1717-1725.

    ObjectiveTo compare the effects of dry needling or manual pressure release on an active trigger point in the upper trapezius on craniocervical flexion test performance, pressure pain thresholds, and cervical range of motion in chronic neck pain.DesignA parallel randomized clinical trial.SettingPhysical therapy service.SubjectsIndividuals with chronic neck pain.MethodsSubjects were randomized to receive dry needling (n = 25) or manual trigger point pressure release (n = 25) on upper trapezius active trigger points. Surface electromyography from the upper trapezius, splenius capitis, sternocleidomastoid, and scalene muscles during performance of the craniocervical flexion test was assessed before and immediately after the intervention as the primary outcome. Neck pain intensity, range of motion, and pressure pain thresholds were the secondary outcomes.ResultsA decrease in sternocleidomastoid activity at all stages of the craniocervical flexion test (time effect, P < 0.001) was found in both groups after the interventions, with no significant between-group difference. Pressure pain thresholds measured over the cervical spine and second metacarpal increased after dry needling when compared with manual trigger point pressure release (P < 0.05). Pain intensity decreased immediately after both treatments with moderate to large effect sizes, whereas cervical range of motion increased for both groups but with small effect sizes.ConclusionA single session of dry needling or manual pressure release over upper trapezius active trigger points promotes limited effects on muscle performance during the craniocervical flexion test, pressure pain thresholds, and cervical range of motion in patients with chronic neck pain.© The Author(s) 2022. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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