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ervical myofascial pain syndrome is a chronic pain disorder characterized by the presence of sensitive points in the trapezius muscles called trigger points which cause local and referred pain. This syndrome typically occurs by repetitive motions done in jobs or hobbies or by stress-related muscle tension.
It affects females more than males and is common in the age group 30-50 years old. It is now increasing among teenagers due to excess cell phone texting. It leads to episodes of headache, neck and upper back pain with limitation of cervical range of motion.
It can be diagnosed clinically by palpation of both trapezii and finding the trigger points that evoke the pain episode. There is no need to use imaging techniques or extensive laboratory investigations to reach the diagnosis.
Treatment options include physical therapy, trigger point injections, pain medications and relaxation techniques. The most common physical therapy modality is the ultrasonic waves and the most recent injection modality is the dry needling.
Our study aimed to compare the efficacy of both ultrasound and dry needling in treating cervical myofascial pain syndrome.
This study was conducted at the Department of Physical Medicine, Rheumatology and Rehabilitation at Ain Shams University Hospital on 30 patients diagnosed with cervical myofascial pain syndrome. Their age group Mean±SD was 40.3±12.4 years old and the disease duration ranged from 3 month to 3 years.
The patients were divided randomly into two groups 15 patients in the ultrasound group and 15 patients in the dry needling group.
In the ultrasound group, we did the application only to the trigger points by 1MHz pulsed technique (1: 1) with 1W/cm2 for 5 minutes for each point. The transducer was kept moving slowly, angled at 90° to the treatment area, during the course of treatment to minimize the risk of causing hot spots.
In the dry needling group, we used filliform acupuncture needles; its diameter was 0.25 mm (32 gauges) needles, we used the peppering technique in which we push the needle in and out through the trigger points to interrupt it.
Every patient received 3 sessions of treatment of either method every week for 3 weeks and was evaluated according to presence or absence of trigger point, changing its nature between active and latent, the cervical ROM and the VAS -10. Then a break for 3 weeks was taken without treatment and re-evaluation was done.
The numbers of trigger points significantly decreased (P<0.001) after treatment in both groups and re increased after stoppage of treatment.
The nature of trigger points changed from active to latent or even disappeared in both groups after treatment, but after the break many of them reappeared again and the latent become active.
The cervical ROM significantly increased (P<0.001) immediately after the 3 weeks treatment duration in both groups and showed limitation again after stoppage of treatment (after another 3 weeks break duration).
The VAS-10 also significantly decreased (P<0.001) immediately after the 3 weeks treatment duration in both groups and increased again after the 3 weeks break