Abstract
Objective. The aim of this study was to compare the efficacy of three interventions for the treatment of myofascial chronic neck pain. Methods. Thirty-six patients were randomly assigned to one of three intervention groups: orthopedic manual therapy (OMT), dry needling and stretching (DN-S), and soft tissue techniques (STT). All groups received two treatment sessions with a 48 h time interval. Outcome measures included neck pain intensity measured using a visual analogue scale, cervical range of motion (ROM), pressure pain threshold for measuring mechanical hyperalgesia, and two self-reported questionnaires (neck disability index and pain catastrophizing scale). Results. The ANOVA revealed significant differences for the group × time interaction for neck disability, neck pain intensity, and pain catastrophizing. The DN-S and OMT groups reduced neck disability. Only the OMT group showed decreases in mechanical hyperalgesia and pain catastrophizing. The cervical ROM increased in OMT (i.e., flexion, side-bending, and rotation) and DN-S (i.e., side-bending and rotation) groups. Conclusions. The three interventions are all effective in reducing pain intensity. Reduction in mechanical hyperalgesia and pain catastrophizing was only observed in the OMT group. Cervical ROM improved in the DN-S and OMT groups and also neck disability being only clinically relevant for OMT group.
Highlights
Neck pain is one of the most frequent pain conditions; the prevalence of neck pain in the general population has been estimated between 10% and 15%, being more common in females than in males [1]
PSC = pain catastrophizing scale, NDI = neck disability index, dry needling and stretching (DN-S) = dry needling + stretching, STT = soft tissue techniques, OMT = orthopedic manual therapy, and 95% CI = 95% confidence interval. ∗P < 0.001
visual analogue scale (VAS) = visual analog scale, DN-S = dry needling + stretching, STT = soft tissue techniques, OMT = orthopedic manual therapy, and 95% CI = 95% confidence interval. ∗P < 0.05. bMean diff = difference among groups for the least squares mean
Summary
Neck pain is one of the most frequent pain conditions; the prevalence of neck pain in the general population has been estimated between 10% and 15%, being more common in females than in males [1]. The prevalence of neck pain in the adult Spanish population has been estimated at 19.5% [2]. There have been many studies to determine the causes of neck pain, but there remains a lack of knowledge about the etiology of this condition. Myofascial pain (MP) is a common variety of such pain, usually caused by myofascial trigger points (MTrPs) [3]. The MTrPs in the neck muscles have been associated with a possible source of referred facial and cranial pain [3]
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