Comparing physical therapy methods to improve head‑neck alignment in neck myofascial pain

Comparative Analysis of Different Physiotherapy Interventions on Craniovertebral Angle in Individuals With Myofascial Pain Syndrome and Radiculopathy: a Randomized Controlled Trial

This will test whether different physical therapy treatments—dry needling, trigger‑point therapy, Maitland mobilizations, TENS, and ultrasound—can improve head‑neck alignment and reduce symptoms in adults 20–40 with cervical myofascial pain.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 100 (estimated)
• Ages: 20 Years to 40 Years
• Sex: All
• Sponsor: National Orthopedic and General Hospital (Academic / other)
• Locations: 1 site (Bahawalpur, Punjab Province)
• Trial ID: NCT07098754 on ClinicalTrials.gov

What this trial studies

This single‑center interventional study randomizes adults with cervical myofascial pain to receive one of several common physiotherapy interventions (dry needling, trigger‑point therapy, Maitland mobilizations, TENS, or ultrasound) delivered over a defined treatment course. The primary outcome is change in craniovertebral angle (CVA) measured by postural analysis, with secondary outcomes including pain intensity, cervical range of motion, and functional measures. Eligible participants are 20–40 years old with mild‑to‑moderate symptoms and a clinical diagnosis of cervical MPS. All treatments and follow‑up assessments are performed at the National Orthopedic and General Hospital in Bahawalpur and the protocol compares relative effects of established modalities.

Who should consider this trial

Good fit: Adults aged 20–40 with a clinical diagnosis of cervical myofascial pain syndrome, mild‑to‑moderate symptoms, and willingness to attend physiotherapy sessions at the Bahawalpur site are ideal candidates.

Not a fit: People outside the 20–40 age range, those with severe radiculopathy, major structural spine disease, prior neck surgery, or inability to attend in‑person sessions may not benefit from or be eligible for this protocol.

Why it matters

Potential benefit: If successful, the preferred therapy could improve head‑neck posture, reduce pain, and help people with cervical myofascial pain return to normal activities.

How similar studies have performed: Previous trials of dry needling and manual therapy have shown short‑term improvements in pain and function for MPS, but evidence that these approaches produce lasting correction of the craniovertebral angle is limited and mixed.

Eligibility criteria

Inclusion Criteria:

1. Age: Participants must be between 20 and 40 years old.
2. Gender: Both genders, Male and Female have equal chance of selection as participant in the study.
3. Diagnosis: Participants must have a confirmed diagnosis of myofascial pain syndrome (MPS), altered cervical posture, restricted range of motion of cervical spine due to muscular spasm etc, altered craniovertebral angle, pain in cervical region or upper extremity and/or radiculopathy by a qualified healthcare professional, based on standardized diagnostic criteria (e.g., clinical examination, imaging studies).
4. Severity: Participants should have mild to moderate symptoms of MPS and/or radiculopathy, as determined by the assessing healthcare provider.
5. Willingness to Participate: Participants must be willing and able to comply physically and mentally with the study procedures, including attending scheduled physiotherapy sessions and completing outcome assessments.
6. Informed Consent: Participants will have to provide written informed consent mendatorily to be selected as participant in the study after receiving detailed information about the study aims, procedures, potential risks, and benefits.

Exclusion Criteria:

1. Severe Comorbidities: Participants with severe comorbidities or medical conditions that may interfere with their ability to participate in the study or confound the interpretation of results will be excluded. C1, C2 compression… vertigo
2. Surgeries: Participants who have undergone surgeries in the cervical or head region in past will be excluded due to potential confounding effects on outcomes.
3. Pregnancy: Pregnant individuals will be excluded from the study due to the potential risks associated with certain physiotherapy modalities and the need for specialized considerations in this population.
4. Contraindications: Participants with contraindications to specific physiotherapy modalities included in the study protocol (e.g., contraindications to dry needling, electrotherapy) will be excluded to ensure participant safety.
5. Inability to Attend Sessions: Participants who are unable to attend scheduled physiotherapy sessions due to logistical constraints (e.g., transportation issues, scheduling conflicts) will be excluded.
6. Cognitive Impairment: Participants with significant cognitive impairment or communication difficulties that may impede their ability to understand and follow study instructions will be excluded.
7. Participation in Other Research: Participants who are currently participating in other research studies involving treatment interventions for MPS and/or radiculopathy will be excluded to avoid potential confounding effects on outcomes and treatment adherence.
8. Malignancies: participants suffering from any kind of malignancies will be excluded from the study.
9. Trauma: Participants having a history of trauma and fractures in head and neck region will also be excluded from the study.

Where this trial is running

Bahawalpur, Punjab Province

• National Orthopedic and General Hospital — Bahawalpur, Punjab Province, Pakistan (Recruiting)

Study contacts

• Study coordinator: Nasir Mehmood, MPhil

Conditions Myofascial Pain Syndrome - Neck; myofascial pain syndrome; dry needling in myofascial pain syndrome; cupping therapy in myofascial pain syndrome; best intervention for myofascial pain syndrome