Abstract
M.Tech. (Chiropractic)
Neck pain is a common and costly complaint in society and many are made to believe that
their neck pain is caused by pinched nerve, compressed disk, arthritis or displaced cervical
vertebrae, when in reality the pain may be solely due to referral from myofascial trigger
points in overworked or traumatized muscles of their upper back and shoulders. Travel and
Simons (1999) demonstrated trapezius muscle of the neck, back and shoulder as the main
cause of mechanical neck pain and stiffness.
The aim of this study was to compare the effects of trigger point therapy using an activator
instrument versus myofascial dry needling in combination with cervical spine adjustment in
the treatment of those with acute or chronic neck pain associated with active trigger point 1
(TrP 1) or trigger point 2 (TrP 2) of upper trapezius muscle, with regards to pain and
disability, pressure pain threshold and cervical spine range of motion.
The clinical study consisted of forty participants, from the ages of 18 and 45, randomly
allocated into two groups of twenty individuals each. Potential participants were examined
and accepted based on inclusion and exclusion criteria. Group 1 received activator trigger
point therapy to upper trapezius TrP 1 or 2 with chiropractic adjustment to restricted
segments of the cervical spine, and group 2 received myofascial dry needling of upper
trapezius TrP 1 or 2 with chiropractic adjustment to restricted segments of the cervical
spine.
Participants were treated four times over a period of two weeks. Subjective data was
collected using the Vernon-Mior Neck Pain and Disability Index and a Visual Analog Scale.
Objective data was collected using an algometer to measure pressure pain threshold of
trapezius TrPs muscles, and a goniometer to measure cervical spine range of motion. All
data was collected at the first and third visits prior to treatment, and at the fifth visit.
The statistical analysis was conducted using nonparametric tests. Friedman’s test was
used to assess whether neck pain, disability, cervical spine range of motion and pressure
pain threshold varied over the three time intervals. Wilcoxon Signed Ranks Pair test was
used for assessment of comparability of the results in each group separately, and the
Mann-Whitney U test was used for comparison of the accumulated data in the two groups.