Myofascial pain syndrome (MPS) and radiculopathy are prevalent musculoskeletal conditions that afflict a substantial portion of the population, causing significant discomfort and impairments in daily functioning. MPS is characterized by localized muscle pain, trigger points, and referred pain, often accompanied by stiffness and restricted range of motion. A common feature shared by individuals with MPS and radiculopathy is the presence of postural abnormalities and balance impairments . The craniovertebral angle, which reflects the relationship between the head and neck, is often compromised in these individuals due to muscle imbalances, pain-related guarding, and structural changes in the spine. Various physiotherapy modalities, including dry needling, manual mobilization and soft tissue release, trigger point therapy, stretching, cupping therapy, and electrotherapy, have been utilized in clinical practice, but their relative efficacy in improving the craniovertebral angle and alleviating symptoms in individuals with MPS and radiculopathy has not been comprehensively compared. Understanding the underlying mechanisms and comparative effectiveness of various physiotherapy interventions is essential for guiding evidence-based clinical decision-making and optimizing treatment outcomes for individuals with MPS and radiculopathy. By elucidating the effects of different treatment modalities on the craniovertebral angle and associated outcomes, this research endeavor aims to contribute to the development of more tailored and effective physiotherapy approaches for improving the well-being of individuals affected by these debilitating musculoskeletal conditions.
Age: Participants must be between 20 and 40 years old.
Gender: Both genders, Male and Female have equal chance of selection as participant in the study.
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).
Severity: Participants should have mild to moderate symptoms of MPS and/or radiculopathy, as determined by the assessing healthcare provider.
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
Surgeries: Participants who have undergone surgeries in the cervical or head region in past will be excluded due to potential confounding effects on outcomes.
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.
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.
Parallel
Dry Needling
Other interventionwill use dry needles of different recommended sizes to intercept the trigger points will add on myofascial release technique manually.
Trigger point therapy
Other interventionwill release trigger points by manual pressure using trigger point therapy technique protocols will ad on stretching techniques
Maitlands' Mobilizations
Other interventionMaitlands' Mobilizations Grade-1\& Grade-2 will be applied to upper thoracic and cervical regions dry cupping therapy will be applied as ad on therapy
Tens and ultrasound
Other interventionTENS and ultrasound will be applied according to recommended dosages followed by stretching and Range of motion activities
Craniovertebral (CV) Angle
Angle between horizontal line crossing spinous process of C7 and line joining the same with tragus of ear. it is assessed using digital photography and then calculating angle using MicroDiCom Software.
Pain Severity
Pain severity will be checked by Numeric Pain Rating Scale (NPRS). this scale consists of 0-10 values with 0 being no pain and 10 being the worst possible pain. Increasing pain scores show high severity of pain and decreasing/less scores show less severity of pain.
Balance
Balance will be assessed using Y Balance Test. this test measures distance of reach on posterior side, anterolateral and anteromedial sides of one leg from keeping one foot stationary on a center point. Distance/reach is measured in cm. Higher values show better balance then lower values of reach in any direction.
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