COMPARATIVE EFFECTIVENESS OF DRY NEEDLING, INSTRUMENT-ASSISTED SOFT TISSUE MOBILIZATION (IASTM), AND CONVENTIONAL PHYSIOTHERAPY ON PAIN AND CERVICAL RANGE OF MOTION IN TRIGGER POINTS OF UPPER TRAPEZIUS: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Active upper trapezius trigger points are a leading cause of neck pain and functional disability i.e restricted range of motion at neck. Although multiple physiotherapy modalities are clinically used, high-quality comparative evidence is scarce.

Objective: To compare the effects of Dry Needling (DN), Instrument-Assisted Soft Tissue Mobilization (IASTM), and Conventional Physiotherapy on pain, disability and cervical ROM on patients with active trigger points in upper trapezius muscle.

Methods: A single-blinded randomized controlled trial was conducted in public and private physiotherapy clinics in Karachi, Pakistan. Seventy-five patients with chronic cervical MPS (25 per group) aged 25–55 years were randomized to: Group A (DN), Group B (IASTM), and Group C (Conventional Physiotherapy). Outcomes included Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI), cervical ROM (CROM goniometer), and trigger point count. Data were analyzed using ANOVA with Tukey, LSD, and Bonferroni post-hoc tests (p < 0.05) in SPSS version 25.0.

Results: Significant post-treatment differences were observed among the groups for pain (F = 173.23, p < 0.001), disability (χ² = significant across groups), cervical ROM (Flexion: F = 291.02, p < 0.001; Lateral Flexion: F = 38.43–101.04, p <0.001), and trigger point resolution. Group A showed the greatest pain reduction (NPRS 8.20→0.96), disability improvement, and ROM gains, followed by Group B. Group C demonstrated the smallest improvements.

Conclusion: DN produced superior outcomes compared with IASTM and conventional physiotherapy in reducing pain, improving cervical ROM, and resolving myofascial trigger points.

Keywords: Dry Needling, IASTM, Cervical Myofascial Pain Syndrome, Trigger Points, Neck Pain, Randomized Controlled Trial.