Dry Needling on the neck and cervical spine can provide relief for neck pain, but can the lower traps be a part of the issue as well?

Effectiveness of dry needling on the lower trapezius in patients with mechanical neck pain: a randomized controlled trial

Daniel Pecos-Martín¹, F Javier Montañez-Aguilera², Tomás Gallego-Izquierdo¹, Alicia Urraca-Gesto³, Antonia Gómez-Conesa⁴, Natalia Romero-Franco¹, Gustavo Plaza-Manzano⁵

Affiliations

PMID: 25582412
DOI: 10.1016/j.apmr.2014.12.016

Abstract

Objective: To evaluate the effect of dry needling into a myofascial trigger point (MTrP) in the lower trapezius muscle of patients with mechanical idiopathic neck pain.

Design: A single-center, randomized, double-blinded controlled study.

Setting: Patients were recruited from the student population of a local hospital by advertisement in the university clinic from January 2010 to December 2011.

Participants: Patients (N=72) with unilateral neck pain, neck pain for ≥3 months, and active trigger points in the lower trapezius muscle were randomly assigned to 1 of 2 treatment groups. All the patients completed the study.

Interventions: Dry needling in an MTrP in the lower trapezius muscle, or dry needling in the lower trapezius muscle but not at an MTrP.

Main outcome measures: The visual analog scale (VAS), Neck Pain Questionnaire (NPQ), and pressure-pain threshold (PPT) were assessed before the intervention and 1 week and 1 month postintervention.

Results: Treatment with dry needling of the lower trapezius muscle close to the MTrP showed decreases in pain and PPT as well as an improvement in the degree of disability (P<.001) compared with the baseline and control group measurements (P<.001). The dry-needling technique performed in the MTrP showed more significant therapeutic effects (P<.001).

Conclusions: The application of dry needling into an active MTrP of the lower trapezius muscle induces significant changes in the VAS, NPQ, and PPT levels compared with the application of dry needling in other locations of the same muscle in patients with mechanical neck pain.

Keywords: Neck pain; Rehabilitation; Trigger points.

What does this Mean?

CORE Physical Therapy in Omaha Explains…

By Dr. Mark Rathjen PT DPT CSCS

17660 Wright Street. suites9/10

“The application of dry needling into an active MTrP of the lower trapezius muscle induces significant changes in the VAS, NPQ, and PPT levels compared with the application of dry needling in other locations of the same muscle in patients with mechanical neck pain.”

The article clearly expresses an interesting side note on the treatment of patients with neck pain and dry needling. Needling of the lower trap provided more relief and more significant changes to the indicators and markers of neck pain. It added to the affect of dry needling in the more traditional areas of mechanical neck pain.

The neck is a very complicated structure and area of the body. There are many supporting structures of the cervical spine. Clearly, this research dating back to 2015, would suggest the root issue of mechanical issues may be in the lower to mid trap region. Often ignored as it can be removed from areas of the symptoms of neck pain, this is an important component to address is physical therapy.

This is another example that would illustrate symptoms are just that. Causes of the symptoms are not always as simple as they appear. A qualified Doctor of Physical Therapy with specialized training is one of the best tools to determine the root cause of an issue. Pick your Doctor of Physical Therapy wisely.

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