Dry Needling and Kinesio Taping in the Treatment of Myofascial Pain Syndrome

The aim of this study is to compare the effectiveness of kinesio tape and dry needling in the treatment of myofascial pain syndrome of the trapezius muscle.

Myofascial pain syndrome (MPS) is a common problem with manifesting itself such as trigger points, taut bands, range of motion limitations and pain. One of the most common place for MPS is neck region and trapezius muscle is the common cause of these symptoms and 9 different trigger point location has been identified on trapezius muscle. Myofascial trigger points, characterized by hypersensitive nodules, can be palpated in stretched bands in the affected muscles. In order to eliminate trigger points fascial releasing, dry needling, kinesio taping and other physical therapy applications can be used. Although there are several studies investigating the effectiveness of Kinesio taping (KT) and Dry needling(DN) methods in MPS, it is controversial which one is superior to others. The aim of this study is to compare the effects of exercise, KT, and DN methods on pain and disability in the treatment of upper trapezoidal muscle MPS.

Patients will be aware of group distribution due to the nature of the taping and DN procedures. Therefore, the only outcome assessor will be blinded

Taping will be performed on sitting position with contralateral lateral flexion and flexion of the neck, using muscle technique with I strip and stretching the head at the maximum level in order to benefit from the muscle release effect. Kinesio tape was applied directly on muscle with 0% stretching.

The trigger point on the taut band will be held with the thumb and forefinger from below and above. In the needling technique, a 0.25 * 25-mm with nickel handle, disposable sterile steel acupuncture needle will be used. The needle tip will be inserted perpendicularly into the subcutaneous tissue and inserted into the muscle until the trigger point in the taut band was found. The same point will be pinned 8-10 times with fast needle movements inside and out. Then the needle tip will pulled back so that it did not come out of the skin, and the bottom, top and sides of the first entered point were also pinned. This procedure was applied to all trigger points in the trapeze muscle.

Pain pressure threshold (PPT). was assessed with an analogue algometry (Baseline, FEl Inc. White Plains, NY,USA) with 1 cm2 rubber tip was used to measure the pain pressure threshold. Algometer perpendicularly placed over spinous process of T1 on prone position and pressure progressively increased 1 kg/s until patients verbally reported pain under the tip of algometer or referring pain. Measurement repeated three times and average score recorded.

The patient was asked to mark the severity of his or her pain with active motion on a horizontal line 100 millimeters in length. The intensity of the pain was calculated by measuring the area in which the individual marked between 0 (no pain) and 10 (the most severe pain I felt in my life).

Perceived disability of patients was assessed with 10-item item Neck Disability Index (NDI),which a modified from Oswestry Low Back Pain Disability Index to assess with a score range of 0 to 50.

Change in the perception of the symptoms after the treatment was measured by a Global Perceived Effect Scale. Patients were asked to rate change between 1 completely recovered, 4 unchanged, 7 vastly worse on a horizontal likert scale.

Inclusion Criteria: Being diagnosis with MPS and having active myofascial trigger points on trapezius muscle Exclusion Criteria: Fibromyalgia a history of myofascial trigger point injection acute trauma inflammatory joint or muscle disease infection or malignancy on cervical region neurological disorders cervical radiculopathy or myelopathy inadequate cooperation for the treatment a history of neck surgery or spinal degeneration