The goal of this clinical trial is to assess and compare the efficacy of dry needling (minimally invasive treatment by using a tiny needle) combined with two types of stretching techniques in patients with neck pain for more than 3 months. The main questions it aims to answer are:
Which combination of treatment will 1.give faster relief of pain? 2.improve neck range of motion? and 3.improve disability level of a person with neck pain.
Participants who are interested will be selected according to eligibility criteria. Participants will be divided into two groups. Initially researcher will assess and interview the participants. Two groups will receive two different combinations of interventions. Pre and post measurements will be obtained and then treatment efficacy will be assessed.
Presence of neck pain for at least 3 months or more
Presence of trigger points in the upper trapezius muscle, either unilaterally or bilaterally
Age between 18 and 60 years
Having an ongoing infection or fever
Presence of shoulder pathology, such as tendinopathy, impingement syndrome, capsulitis, or bursitis
History of direct trauma to the shoulder or neck
Immunosuppressed individuals (e.g., those with cancer)
Parallel
Dry Needling
Procedure/SurgeryTreatment protocol: 1. Dry needling: Prone position, identify trigger points in upper trapezius, use Hong technique with 50mm/0.25 gauge needle, eliciting local twitch response. 2. Passive stretching: Supine position, cervical spine stretched just short of restriction, hold for 30s with 20s rest, repeat 3 times. 3. Muscle Energy Technique: Supine position, identify restriction barrier, move spine away from barrier, instruct patient to isometrically contract opposing movement (25% strength), hold for 7-10s, then stretch towards new barrier for 30s, repeat 3 times.
Neck pain
Visual Analog Scale (VAS) 0: Represents the minimum value, such as "no pain" or "no discomfort." 100: Represents the maximum value, such as "worst pain imaginable" or "extreme discomfort.
Neck Range of Motion
Neck flexion, Extension, Side flexion to affected side, Side flexion to unaffected side, Rotation to affected side and Rotation to unaffected side
Neck disability level
Neck Disability Index Structure: Contains 10 items, each scored on a 0-5 scale Scoring: Total score ranges from 0 to 50, Higher scores indicate greater disability.
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