Neck Muscle Stiffness in Participants With and Without Chronic Neck Pain: A Shear-Wave Elastography Study

Objectives

The purpose of the present study was to investigate differences in neck muscle stiffness between patients with chronic neck pain and asymptomatic control group.

Effects of Deep Cervical Flexor Training on Pressure Pain Thresholds Over Myofascial Trigger Points in Patients With Chronic Neck Pain

Objective

The purpose of this study was to assess the effects of a low-load training program for the deep cervical flexors (DCFs) on pain, disability, and pressure pain threshold (PPT) over cervical myofascial trigger points (MTrPs) in patients with chronic neck pain.

Methods

Thirty patients with chronic idiopathic neck pain participated in a 6-week program of specific training for the DCF, which consisted of active craniocervical flexion performed twice per day (10-20 minutes) for the duration of the trial. Perceived pain and disability (Neck Disability Index, 0-50) and PPT over MTrPs of the upper trapezius, levator scapulae, and splenius capitis muscles were measured at the beginning and end of the training period.

Results

After completion of training, there was a significant reduction in Neck Disability Index values (before, 18.2 ± 12.1; after, 13.5 ± 10.6; P < .01). However, no significant changes in PPT were observed over the MTrPs.

Conclusion

Patients performing DCF training for 6 weeks demonstrated reductions in pain and disability but did not show changes in pressure pain sensitivity over MTrPs in the splenius capitis, levator scapulae, or upper trapezius muscles.     

Myofascial Trigger Points,Pain, Disability,and Sleep Quality in Individuals With Mechanical Neck Pain

ObjectiveThe purpose of this study was to investigate the presence of active myofascial trigger points (MTrPs) in a greater number of muscles than previous studies and the relation between the presence of MTrPs, the intensity of pain, disability, and sleep quality in mechanical neck pain.MethodsFifteen patients with mechanical neck pain (80% women) and 12 comparable controls participated. Myofascial trigger points were bilaterally explored in the upper trapezius, splenius capitis, semispinalis capitis, sternocleidomastoid, levator scapulae, and scalene muscles in a blinded design. Myofascial trigger points were considered active if the subject recognized the elicited referred pain as a familiar symptom. Myofascial trigger points were considered latent if the elicited referred pain was not recognized as a symptom. Pain was collected with a numerical pain rate scale (0-10); disability was assessed with Neck Disability Index; and sleep quality, with the Pittsburgh Sleep Quality Index.ResultsPatients exhibited a greater disability and worse sleep quality than controls (P < .001). The Pittsburgh Sleep Quality Index score was associated with the worst intensity of pain (r = 0.589; P = .021) and disability (r = 0.552; P = .033). Patients showed a greater (P = .002) number of active MTrPs (mean, 2 ± 2) and similar number (P = .505) of latent MTrPs (1.6 ± 1.4) than controls (latent MTrPs, 1.3 ± 1.4). No significant association between the number of latent or active MTrPs and pain, disability, or sleep quality was found.ConclusionsThe referred pain elicited by active MTrPs in the neck and shoulder muscles contributed to symptoms in mechanical neck pain. Patients exhibited higher disability and worse sleep quality than controls. Sleep quality was associated with pain intensity and disability. No association between active MTrPs and the intensity of pain, disability, or sleep quality was found.     

Effects of Kinesio Taping on Post-Needling Induced Pain After Dry Needling of Active Trigger Point in Individuals With Mechanical Neck Pain

ObjectiveThe purpose of this study was to assess the effectiveness of the application of kinesio taping in reducing induced pain after dry needling of active trigger points (TrPs) to the upper trapezius muscle.MethodsConsecutive patients had mechanical neck pain (n = 34, 44% female) with active TrPs in the upper trapezius muscle. All participants received dry needling into upper trapezius active TrPs. Then, they were randomly divided into a kinesio taping group, which received an adhesive tape (Kinesio Tex), and a control group, which did not receive the taping. The numeric pain rating scale was assessed (0-10) at post-needling; immediately after; and 24 hours, 48 hours, and 72 hours after needling. Neck- and shoulder-related disability was assessed before and 72 hours after needling with the Neck Disability Index (NDI) and the Shoulder Pain and Disability Index, respectively. The pressure pain threshold (PPT) over the TrP was also assessed post-needling, immediately post-intervention, and 72 hours after needling.ResultsThe analysis of covariance did not find a significant group × time interaction (P = .26) for post-needling soreness: both groups exhibited similar changes in post-needling induced pain (P < .001). No significant group × time interactions were observed for changes in NDI (P = .62), SPADI (P = .41), or PPTs (P = .52): similar improvements were found after the needling procedure for the NDI (P < .001), Shoulder Pain and Disability Index (P < .001), and PPT (P < .001). The number of local twitch responses and sex (all, P > .30) did not influence the effect for any outcome.ConclusionThe application of kinesio taping after dry needling of active TrPs in the upper trapezius muscle was not effective for reducing post-needling induced pain in people with mechanical neck pain. Further, the application of kinesio taping as a post-needling intervention did not influence short-term changes in disability.     

Relationship Between Intensity of Neck Pain and Disability and Shoulder Pain and Disability in Individuals With Subacromial Impingement Symptoms: A Cross-Sectional Study

ObjectiveThis study aimed to verify a possible relationship between shoulder disability and shoulder pain intensity and the variables related to cervical-spine dysfunction, and determine which of these can differentiate moderate to severe shoulder pain (>4 on a numerical rating scale [NRS]) from mild shoulder pain (≤4 on the NRS) in individuals with subacromial impingement symptoms.MethodsOne hundred and forty volunteers with shoulder pain were evaluated. Demographic information and variables related to the shoulder and neck were collected. Self-reported pain and disability of the shoulder and cervical spine were measured using the Shoulder Pain and Disability Index (SPADI) and Neck Disability Index (NDI) questionnaires, respectively. An NRS was used to measure pain in the shoulder and cervical spine. A purposeful modeling strategy was used to determine the best model to predict shoulder disability and shoulder pain (dependent variables). Multiple logistic regression analysis followed by receiver operating curve analysis was used to determine which variables better differentiated moderate to severe shoulder pain from mild shoulder pain.ResultsVariables such as Neck Disability Index (NDI) score (β = 1.09, P = .00) and age (β = −0.19, P = .03) were associated with the total SPADI score. Neck pain was significantly associated with shoulder pain (β = 0.40, P = .00). The combination of variables predicting moderate to severe shoulder pain was total SPADI score (odds ratio [OR] = 1.15, P = .003), neck pain (OR = 3.20, P = .04), and age (OR = 1.01, P = .05).ConclusionOur results demonstrate the important connection between shoulder- and neck-related symptoms in individuals with subacromial impingement symptoms.     

Correlation Between Chronic Neck Pain and Heart Rate Variability Indices at Rest: A Cross-sectional Study

ObjectiveThe purpose of this study was to correlate the heart rate variability (HRV) indices with variables of pain that were experienced by individuals with chronic neck pain.MethodsThis was a blinded cross-sectional study. Individuals with chronic neck pain (n = 15) and healthy participants (n = 15), both sedentary and between 18 and 45 years of age, were included. The neck pain was assessed with the Numerical Rating Scale at rest and during cervical movements, Neck Disability Index, Catastrophic Thoughts about Pain Scale, and Tampa Scale of Kinesiophobia. The HRV indices (linear and nonlinear) were used for assessment of autonomic function at rest (in supine, sitting, and standing positions).ResultsWe observed significant correlations between the NRS, Neck Disability Index, and Catastrophic Thoughts about Pain Scale with the linear and nonlinear HRV indices (P < .05, r ≥ 0.362), so that the worst HRV indices are associated with conditions of more intense and disabling neck pain.ConclusionThe HRV indices were significantly associated with pain intensity, disabilty, and catastrophizing in individuals with chronic neck pain.     

Comparison Between Neck Pain Disability and Cervical Range of Motion in Patients With Episodic and Chronic Migraine: A Cross-Sectional Study

ObjectiveThe purpose of this study was to evaluate neck pain–related disability and cervical range of motion (CROM) in patients with episodic migraine (EM) and chronic migraine (CM) and to examine the correlation of both outcomes.MethodsThis cross-sectional study consisted of 91 patients with EM and 34 with CM. Cervical range of motion was measured with the CROM device, and pain during the cervical movement was recorded. Self-reported disability related to neck pain was assessed with the Neck Disability Index.ResultsPatients with CM showed higher Neck Disability Index scores and more moderate and severe disability (P = .01). Severe disability as a result of neck pain was associated with 7.6-fold risk of developing CM (P = .003). No significant differences in CROM were identified between groups. Moderate negative correlations between CROM and disability were found for 4 motions within the CM group (− 0.60 < r < − 0.39) and with 3 in the EM group (− 0.48 < − 0.45). Disability was positively and moderately correlated to pain evoked during CROM in both groups (0.34 < r < 0.51).ConclusionThis study found that neck pain was highly prevalent in patients with migraine. Neck pain–related disability increased with increased frequency of the migraine attacks and was associated with the risk of migraine chronicity. The correlation between CROM and neck pain disability was more evident in patients with CM and in patients with pain during cervical movement.     

Association of Both Scapular Upward Rotation and Scapulothoracic Muscle Lengths With Shoulder Pain,Function, and Range of Movement

ObjectiveOur aim was to analyze whether shoulder pain is related to scapular upward rotation (SUR) or to the lengths of the pectoralis minor and levator scapulae muscles.MethodsThis cross-sectional, observational study was carried out in 3 primary-care centers; 54 individuals with chronic shoulder pain participated. Scapular upward rotation and the lengths of the pectoralis minor and levator scapulae muscles were assessed.ResultsThe level of association was small between shoulder pain and function and (1) the lengths of the pectoralis minor (r = 0.08, P = .93) and levator scapulae (r = −0.01, P = .57) muscles and (2) SUR at 45° (r = 0.17, P = .21), 90° (r = 0.08, P = .57), and 135° (r = 0.10, P = 0.45) of shoulder elevation.ConclusionThe relationship was small between shoulder pain and function and (1) SUR (45°, 90°, and 135° of shoulder elevation) and (2) the lengths of the pectoralis minor and levator scapulae muscles. Thus, the use of SUR and pectoralis minor and levator scapulae lengths in shoulder assessment should be undertaken with caution. Other factors such as psychological factors, central/peripheral sensitization, and intrinsic properties of the tissue have to be taken into account.     

Evaluation of repeatability of pressure algometry on the neck muscles for clinical use

Neck and shoulder pain is a common disorder which is often associated with a low-pressure pain threshold (PPT) of muscle tissues as manifested by hyperalgesia on palpation or the use of a pressure algometer. The objective of the present study was to evaluate the intratester repeatability of pressure algometer (Force-Five) on the neck and shoulder area in women with neck pain. The study was cross-sectional with single-group repeated measurements. PPT measurements in 20 women with chronic non-specific neck pain were measured on consecutive days at the levator scapulae, at two points on the trapezius muscles on each side and at the sternum as the only non-muscular site. The intratester repeatability of the PPT measurements was satisfactory or good (Intraclass correlation coefficient (ICC 0.78-0.93). The coefficient of repeatability ranged from 16.8 to 24.4N/cm2 and the coefficient of variation ranged from 10% to 22%, depending on the site tested. Considerable individual variation was observed when consecutive measures were analysed against their mean. On the group level the repeatability of the measurements allows the pressure algometer to be used for research purposes. However, on the individual level, due to the considerable variation found in the PPT results, caution is advised when interpreting the results in clinical practice.     

Psychometric Properties of Pressure Pain Thresholds Measured in 2 Positions for Adults With and Without Neck-Shoulder Pain and Tenderness

ObjectiveThe purpose of this study was to determine the psychometric properties of pressure pain threshold (PPT) testing in adults with and without neck-shoulder pain and tenderness and to compare the differences in PPT measurements between the seated and prone positions.MethodsThirty asymptomatic adults and 30 symptomatic patients with intermittent neck-shoulder pain and tenderness completed the study. A pressure algometer was used to assess PPTs at specific points on the middle deltoid, levator scapulae, and upper trapezius muscles of the dominant side of the asymptomatic individuals and the painful side of the patients. Four trials were performed on each muscle in both the seated and prone positions. To determine between-day reliability, a subset of the participants returned to repeat the testing.ResultsThe intraclass correlation coefficients showed good to excellent within-session reliability and fair to excellent between-day reliability of PPT measurements in both the seated and prone positions for both groups. There were significant differences between groups for all muscles in both positions (P < .05) except for the upper trapezius muscle in the prone position. In addition, significant differences were found between the 2 testing positions for the middle deltoid and upper trapezius muscles in the symptomatic group and for the middle deltoid muscle in the asymptomatic group.ConclusionThe results of the study suggest that PPT testing could be useful for distinguishing individuals with and without neck-shoulder pain and tenderness. Further, the patient’s position should be considered when testing PPT, specifically at the middle deltoid or upper trapezius muscles.     

After-effects of neck muscle vibration on sensorimotor function and pain in neck pain patients and healthy controls – a case-control study

Purpose: Neck muscle vibration immediately improves cervical joint position sense and dynamic postural control but increases pressure pain thresholds in neck pain patients. The aim of this study was to explore longer lasting effects of neck muscle vibration on sensorimotor control and pressure pain threshold.

Materials and methods: Five series of neck muscle vibration were delivered to 15 neck pain patients and 11 healthy controls in this case control study. Outcomes were cervical joint position sense, arm-matching acuity, and pressure pain threshold at the zygapophyseal joint of C2/C3, the angulus superior, and the tibialis anterior muscle.

Results: Cervical joint position sense acuity improved in neck pain patients and declined in healthy controls even after 24?h. Arm-matching acuity improved in patients assessed after 15?min, as was pressure pain threshold at the angulus superior in neck pain patients. In contrast, changes in the pressure pain threshold at the tibia were only observable immediately after vibration.

Conclusion: Neck muscle vibration induced short-lasting general as well as longer-lasting specific effects on analgesia and sensorimotor function. Based on our observations, future studies should investigate potential benefits of neck muscle vibration as adjunct to physical therapy in order to improve cervical sensorimotor function.

• Implications for Rehabilitation

• A single session of neck muscle vibration improves cervical joint position sense in neck patients for up to 24?h.

• Neck muscle vibration improves arm-matching acuity in neck pain patients.

• Neck muscle vibration increases pressure pain thresholds at the stimulated place but decrease pressure pain thresholds more distally.

• Neck muscle vibration shows distinct effects in neck pain patients and healthy control.

     

Traditional physical therapy exercises combined with sensorimotor training: The effects on clinical outcomes for chronic neck pain in a double-blind,randomized controlled trial

ObjectiveThis study examined the effects of combining traditional physical therapy exercises with sensorimotor training on joint position sense, pain, muscle endurance, balance and disability in patients with chronic, non-specific neck pain.DesignDouble-blind, randomized controlled trial.SubjectsA total of 53 patients with chronic non-specific neck pain were randomized to either traditional or combined exercise groups.InterventionsAll patients received 12 sessions of supervised intervention 3 times per week. The traditional group performed traditional exercises, and the combined exercise group performed sensorimotor training in addition to traditional exercises.Outcome measuresJoint position sense, pain, neck flexor muscle endurance test, 10 Meter Walk Test, step test, and the Neck Disability Index.ResultsThe combined exercise group showed significantly greater improvement compared to the traditional group in joint position sense during extension, flexion, right rotation, the 10 m walk test with head turn, and the step test. Pain intensity, muscle endurance, and disability improved in both groups. Additionally, there was a higher degree of effect on muscle endurance in the combined exercise group compared to a moderate effect in the traditional group.ConclusionsA combination of sensorimotor training with traditional physical therapy exercises could be more effective than traditional exercises alone in improving joint position sense, endurance, dynamic balance and walking speed.     

Ultrasound Investigation of Dorsal Neck Muscle Deformation During a Neck Rotation Exercise

ObjectivesNeck-specific exercise can reduce neck pain and increase function, but information on how different neck muscle layers are activated during neck exercises is scarce. The aim of this study was to investigate deformation and deformation rate in 5 dorsal neck muscles and the correlation among these muscles during a loaded dynamic exercise used in clinical practice.MethodsDeformation and deformation rate were investigated in 5 dorsal right-sided neck muscles in 20 individuals without neck pain using ultrasonography and speckle-tracking analyses. Repeated-measures analysis of variance was used to measure differences between the muscles, and correlations between neck muscles were analyzed with Kendall's tau.ResultsDeformation in left (contralateral) rotation showed significant differences among the muscles (P = .01), with higher deformation of the semispinalis capitis muscle compared with the trapezius muscle (P = .02). There were no significant differences among the 5 neck muscles in right (unilateral) rotation (P = .46). There were significant differences in deformation rate among muscles in both right and left rotation (P < .01). The trapezius muscles have the lowest deformation rate in right rotation (P < .01). In left rotation, the trapezius and multifidus muscles showed lower deformation rates compared with most of the other muscles (P < .03). Almost all muscles were correlated in both deformation and deformation rate.ConclusionThe quadruped standing loaded dynamic neck exercise seemed to activate all the investigated neck muscles, with a tendency for more activation of the semispinalis capitis.     

Effects of Corrective Exercises on Posture,Pain, and Muscle Activation of Patients With Chronic Neck Pain Exposed to Anterior-Posterior Perturbation

ObjectivesThis study aimed to evaluate the effects of corrective exercises on posture, pain, and muscle activation of patients with chronic neck pain exposed to anterior-posterior perturbation.MethodsA total of 32 women (37.76 ± 3.83 years) with chronic, nonspecific neck pain were randomized into corrective exercise and control groups. The experimental group underwent a corrective exercise program for 8 weeks, 30 min/d, 3 days per week. The control group received active self-exercise instructions. Neck pain, forward head and protracted shoulder posture, and timing of superficial neck muscle activation were evaluated using the visual analog scale, photogrammetry, and electromyogram, respectively, before and then 48 hours after the 8-week program for both the experimental and control groups. All measurements at pretest and posttest were taken by a blinded assessor.ResultsSignificant alterations were observed in cervical angle (P = .003, effect size = 0.329), shoulder angle (P = .008, effect size = 0.457), neck pain and disability (P = .009, effect size = 0.645), movement control (P = .038, effect size = 0.353), activation onset of the upper trapezius (P = .015, effect size = 0.746), the sternocleidomastoid (P = .018, effect size = 0.879) and cervical erector spinae (P = .031, effect size = 0.765), and the root mean square of the upper trapezius (P = .033, effect size = 0.742), the sternocleidomastoid (P = .041, effect size = 0.587), and the cervical erector spinae (P = .024, effect size = 0.832) in the intervention group from pre- to posttest (P < .05).ConclusionPositive and significant alterations have been observed in the forward head and protracted shoulder posture, the timing of superficial neck muscle activation, neck pain, and disability in female patients with chronic neck pain exposed to anterior-posterior perturbation after performing an 8-week corrective exercise program.     

Osteopathic manipulative treatment combined with exercise improves pain and disability in individuals with non-specific chronic neck pain: A pragmatic randomized controlled trial

PurposeTo determine effectiveness of osteopathic manipulative treatment combined with stretching and strengthening exercises in the cervical region on pain and disability in individuals with non-specific chronic neck pain.Methods90 adults with non-specific chronic neck pain were randomized to either exercises group (EG, n = 45) or osteopathic manipulative treatment associated with exercises group (OMT/EG, n = 45). The primary outcomes were obtained by the use of Numeric Pain-Rating Scale (NPRS), Pressure Pain Threshold (PPT) and Neck Disability Index (NDI). Secondary outcomes included range of motion (ROM) for cervical spine rotation, Fear-Avoidance Beliefs Questionnaire Work/Physical Activity (FABQ-W/PA) and Pain-self efficacy at two different moments: baseline and 4 weeks after the first treatment. Techniques and dosages of OMT were selected pragmatically by a registered osteopath. Generalized Estimating Equations model (GEE), complemented by the Least Significant Difference (LSD) and the intention-to-treat analysis, was used to assess the clinical outcomes.ResultsAnalysis with GEE indicated that OMT/EG reduced pain and disability more than the EG alone after 4 weeks of treatment with statistically significant difference (p < 0,05), as well as cervical active rotation was significantly improved (p = 0.03). There were no between-group differences observed in Pressure Pain Threshold (PPT) measure, Fear-Avoidance Beliefs Questionnaire and Pain-self efficacy.ConclusionThe association between OMT and exercises reduces pain and improves functional disability more than only exercise for individuals with non-specific chronic neck pain.     

The effects of pressure release, phonophoresis of hydrocortisone, and ultrasound on upper trapezius latent myofascial trigger point

Sarrafzadeh J, Ahmadi A, Yassin M. The effects of pressure release, phonophoresis of hydrocortisone, and ultrasound on upper trapezius latent myofascial trigger point.ObjectiveTo compare the effects of pressure release (PR), phonophoresis of hydrocortisone (PhH) 1%, and ultrasonic therapy (UT) in patients with an upper trapezius latent myofascial trigger point (MTP).DesignRepeated-measure design.SettingA pain control medical clinic.ParticipantsSubjects (N=60; mean±SD age, 21.78±1.76y) with a diagnosis of upper trapezius MTP participated in this study. Subjects were randomly divided into 4 groups: PR, PhH, UT, and control (15 in each group). All patients had a latent MTP in the upper trapezius muscle.InterventionsPR, PhH, UT.Main Outcome MeasuresSubjective pain intensity, pain pressure threshold (PPT), and active cervical lateral flexion range of motion were assessed in 6 sessions.ResultsAll 3 treatment groups showed decreases in pain and PPT and an increase in cervical lateral flexion range of motion (P<.001) compared with the control group. Both PhH and PR techniques showed more significant therapeutic effects than UT (P<.001).ConclusionsOur results indicate that all 3 treatments used in this study were effective for treating MTP. According to this study, PhH is suggested as a new method effective for the treatment of MTP.     

Immediate Effects of Dry Needling and Myofascial Release on Local and Widespread Pressure Pain Threshold in Individuals With Active Upper Trapezius Trigger Points: A Randomized Clinical Trial

ObjectiveThis study sought to compare the immediate effects of a single session of dry needling (DN), myofascial release (MR), and sham DN on pressure pain threshold (PPT) and neck pain intensity in individuals with chronic neck pain.MethodsThis was a randomized trial with a blinded outcome assessor. Forty-four individuals with chronic neck pain and unilateral myofascial trigger points in the upper trapezius muscle (UTM) were randomized to receive DN (n = 15), MR (n = 14), or sham DN (n = 15). The PPT over the UTM (ipsilateral and contralateral sides) and the proximal head of the radius (ipsilateral and contralateral to the treated side) and neck pain were assessed immediately and 10 minutes after the intervention.ResultsThere was no significant Group × Time interaction for PPT in the UTM on the treated side (F = 0.63, P = .641) or the contralateral side (F = 1.77, P = .144). However, there was a main effect of time on both the treated side (F = 4.917, P = .001) and the contralateral side (F = 4.70, P = .015), with DN and MR increasing PPT at the UTM. No significant Group × Time × Side interaction was found for PPT at the proximal head of the radius (F = 1.23, P = .276). Within-group analysis revealed a significant increase in PPT on the ipsilateral and contralateral sides in both DN and MR. Neck pain decreased after DN (P < .001), MR (P < .001), and sham DN (P = .008).ConclusionA single application of DN or MR generated local and distant hypalgesic responses superior to placebo. Future trials are needed to examine whether these findings occur in long-term follow-ups.     

Chronic neck pain and muscle activation characteristics of the shoulder complex

IntroductionNeck pain is a very common musculoskeletal complaint in industrialized countries. Theoretically, chronic neck pain is thought to possibly change biomechanics and muscle activation patterns of the shoulder complex, causing its pain and dysfunction in the long term.PurposeThe present cross-sectional study was conducted to compare shoulder complex muscle activation characteristics in patients with chronic non-specific neck pain, compared to healthy participants.MethodTwenty patients with chronic neck pain and twenty healthy participants were recruited for the present study. Surface Electromyographic (sEMG) activity was recorded from four selected muscles (anterior and middle deltoid, upper and lower trapezius) during shoulder elevation with a predetermined load (25–30% of an individual's maximum voluntary exertion).ResultResults revealed only two significant increased onset delays in the anterior and middle deltoid,and a peak delay in the upper trapezius in chronic neck pain patients. Furthermore, increased onset delay for other muscles and decreased peak normalized amplitude (MVE%) for all muscles were found in chronic neck pain patients; however, these findings were not statistically significant.ConclusionThere were relationships between chronic non-specific neck pain and the shoulder muscle activation characteristic; hence, the alteration may be considered a predisposing factor for the shoulder dysfunction in future studies.     

Comparing Trigger Point Dry Needling and Manual Pressure Technique for the Management of Myofascial Neck/Shoulder Pain: A Randomized Clinical Trial

Objective

The aim of this study was to investigate short-term and long-term treatment effects of dry needling (DN) and manual pressure (MP) technique with the primary goal of determining if DN has better effects on disability, pain, and muscle characteristics in treating myofascial neck/shoulder pain in women.

Vacuum myofascial therapy device for non-specific neck pain. A single blind randomized clinical trial

ObjectivesThis study aimed to investigate the efficacy of a vacuum myofascial therapy device (VT) for improving pressure pain thresholds (PPTs), range of motion (ROM), neck pain-related disability, pain, and quality of life in patients with non-specific neck pain.MethodsA randomized controlled trial in which thirty-eight participants with non-specific neck pain (NP) were randomly assigned to either an experimental (VT) or a comparison physical therapy program (PTP) group. The VT group (n = 19) received five sessions of treatment with a vacuum myofascial therapy device while the PTP group (n = 19) received five sessions of massage, ultrasound therapy (US), and transcutaneous electric nerve stimulation (TENS) over two weeks. The outcome measures were the numerical pain rating scale (NPRS), range of motion, quality of life (SF-12), neck disability Index (NDI), and PPTs at the end of treatment and at one-month follow-up.ResultsAlthough both groups experienced improvements in pain, neck disability, range of motion, and pressure pain, these only were statistically significant in the VT group. At one-month follow-up, the VT group still showed improvements in pain, neck disability, and range of motion.DiscussionVacuum myofascial therapy applied with a device offers similar results to other vacuum-based techniques such as cupping therapy. Moreover, in this device the parameters are digitally controlled, which allows for the precise reproduction of treatment.