The effectiveness of cervical adjustment therapy, dry needling of the levator scapulae muscle and the combination of the two in the treatment of chronic mechanical neck pain

M.Tech.The aim of this study was to compare the effectiveness of cervical adjustment therapy, dry needling of the levator scapulae muscle and a combination of the two in the treatment of chronic mechanical neck pain. Forty-five patients were recruited via posters and advertisements from in and around the University of Johannesburg. The participants had to present with bilateral neck pain, decreased range of motion and an active levator scapulae muscles trigger point, which was diagnosed using range of motion and trigger point examination. The participants were randomly allocated into three groups of fifteen participants each. Prior to treatment a full case history, physical examination and cervical regional examination were performed to ensure that the patients were eligible to partake in the clinical trial. Group 1 was the adjusting group; group 2 was the combination group while group 3 was the needling group. Participants were treated five times over a period of three weeks. The objective measurements used in this clinical trial involved a cervical range of motion instrument (C.R.O.M., Performance Attainment Associates) and an algometer (Wagner Instruments). Subjective measurements were achieved using the Neck Pain and Disability Index (Appendix G) and the Numerical Pain Rating Scale (Appendix H). Each measurement was taken prior to treatment on the first and third visits and after treatment on the fifth visit with three measurements per participant overall. The statistical analysis was conducted using the Kruskal-Wallis, Friedman and Wilcoxon tests to compare data. The results indicated that the three groups responded favourably to their respective treatments. Overall, this study has indicated that dry needling of the Levator scapulae muscle provides no statistically significant contribution to the conservative treatment of mechanical neck pain caused by levator scapulae trigger points