Dry Needling Versus Strain-counterstrain on the Upper Trapezius (DNJ)

• Pain at rest [ Time Frame: 6 sessions ] [ Designated as safety issue: No ]
  Visual Analogue Scale
• Neck Disability [ Time Frame: 6 sessions ] [ Designated as safety issue: No ]
  Neck Disability Index
• Electromyographic activity of the upper trapezius [ Time Frame: 6 sessions ] [ Designated as safety issue: No ]
  Surface EMG will be recorded (MP 100 de BIOPAC Systems; Goleta, CA, USA). Electrodes will be located to register activity of the Upper trapezius, according to SENIAM guidelines. Microvolts of activity at rest will be recorded. Data will be normalized through calculation of maximal voluntary contraction, so that final data will be reported as a percentage.

This study investigates the effect of two different techniques (dry needling and Strain-counterstrain manual technique) on the upper trapezius myofascial trigger point (MTP). Subjects with active or latent MTP in this location of the muscle will be identified and will be randomly assigned to one out of three groups: dry needling, strain-counterstrain or placebo manual technique. Pain pressure threshold, provoked pain, pain at rest, neck disability and EMG activity of the upper trapezius will be registered before and after six sessions of treatment.

• Other: Dry needling
  Deep dry needling until achieving twitch response of the muscle
• Other: Strain-counterstrain technique
  A manual technique to release tension of painful muscles.
• Other: Placebo manual technique
  A placebo technique, consisting of manual contact of the therapist with the patient without any further therapeutic approach

• Experimental: Dry Needling of trigger point
  Deep dry needling will be applied on the upper trapezius myofascial trigger point
  Intervention: Other: Dry needling
• Experimental: Strain-counterstraing technique
  This manual technique will be applied at the upper trapezius.
  Intervention: Other: Strain-counterstrain technique
• Placebo Comparator: Placebo manual technique
  A technique simulating strain-counterstrain, but without any therapeutic manoeuvre will be applied at the upper trapezius site.
  Intervention: Other: Placebo manual technique

Inclusion Criteria:

• Active myofascial trigger point at the upper trapezius

Exclusion Criteria:

• Diagnosed fibromyalgia
• Cervical radiculopathy
• Facial neuralgia
• Coagulation alteration
• Cancer
• Allergy (included needles)
• History of cervical or shoulder surgery
• History of deep venous thrombosis
• History of myopathy
• History of infiltration at upper trapezius trigger point
• Anticoagulant medication
• Aspirin intake during the last 3 days
• Drug intake (AINES, narcotics, antiepileptics, or any other analgesic medication)
• Pregnancy