This study will compare two physiotherapy treatments for adults with long-lasting neck pain and tender muscle spots, called trigger points, in the upper trapezius muscle between the neck and shoulder. The aim is to find out which treatment was more effective in reducing pain, improving neck movement, and reducing difficulty with daily activities.
The study will includ 76 adults aged 20-40 years at Mayo Hospital, Lahore, Pakistan. Participants will be assigned by chance to one of two treatment groups. One group will receive a cooling spray followed by gentle stretching of the affected muscle. The other group will receive sustained pressure applied by a therapist to the tender muscle spots. Both groups also will receive routine physiotherapy, including heat, exercises, and advice about neck care and posture.
Participants will receive six treatment sessions over two weeks. Pain, neck movement, and difficulty with daily activities will be assessed before treatment, immediately after the first session, and after the sixth session.
None
None
Parallel
Spray and Stretch Technique
Other interventionWith the participant seated comfortably, a vapocoolant spray will be applied in 3-5 parallel sweeps over the upper trapezius muscle, followed by stretching of the affected muscle. The procedure will be repeated 2-3 times per session. Participants will receive six sessions, three times weekly for two weeks, alongside conventional physiotherapy.
Sustained Pressure Technique
Other interventionThe therapist will apply sustained manual pressure to upper trapezius trigger points, adjusting the pressure according to the participant's tolerance. Pressure application will be repeated during each session. Participants will receive six sessions, three times weekly for two weeks, alongside conventional physiotherapy.
Conventional Physiotherapy
Other interventionBoth groups will receive a hot pack over the upper trapezius for 10 minutes, cervical isometric exercises, active neck movement exercises, shoulder shrugs, retraction exercises, and advice on posture and neck care. Exercises will be progressed during the second week. Conventional physiotherapy will provide during six sessions, three times weekly for two weeks.
Pain intensity
Pain Intensity Measured Using the Visual Analogue Scale
Cervical range of motion
Active cervical range of motion will be measured in degrees using a goniometer. Measurements included flexion, extension, right and left lateral flexion, and right and left rotation. Higher values indicate greater range of motion.
Neck Related Disability Measured Using the Neck Disability Index
The Neck Disability Index assesses the effect of neck pain on daily activities through 10 items, each scored from 0 to 5. The total raw score ranges from 0 to 50, with higher scores indicating greater disability.
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