Dry needling versus cervical spine manipulation combined with dry needling in the treatment of subscapularis myofascial trigger points

M.Tech. (Chiropractic)Abstract: PURPOSE: Shoulder pain is one of the most common disorders that patients present with in practice. The most common cause of shoulder pain is a musculoskeletal problem that is chronic and recurrent. It is considered to be the main contributor towards non-traumatic upper limb pain. One of the identifiable causes of shoulder pain is myofascial pain syndrome which is caused by myofascial trigger points and produces symptoms similar to other shoulder pain syndromes. The subscapularis muscle is the largest of the rotator cuff muscles and is subjected to a large amount of biomechanical strain as well as neuromuscular tension. The aim of this study was to compare the effectiveness of treating shoulder pain with either dry needling the subscapularis muscle or with a combination treatment of dry needling the subscapularis muscle as well as cervical spine manipulations in order to determine which of the two treatment protocols are more effective. METHODS: This study was a comparative study consisting forty participants between the ages of 18 and 40 years old with shoulder pain that were divided into 2 groups. Prior to becoming a participant in this study, individuals were assessed according to the inclusion and exclusion criteria. A Numerical Pain Rating Scale, clinical case history, full physical examination, cervical spine regional, shoulder regional and pressure algometer readings were completed. The method for treatment for each participant was determined by random group allocation. Group 1 received dry needling of the subscapularis muscle and group 2 received a combination treatment of subscapularis muscle dry needling and cervical spine manipulations. Subjective and objective readings were based on the above mentioned treatments. All participants received six treatments over a period of three weeks. MEASUREMENTS: Subjective measurements were obtained by the Numerical Pain Rating Scale and the objective measurements were obtained using the hand-held pressure algometer. The data was collected on the initial, fourth and seventh consultations. OUTCOME: With the subjective readings, the intragroup analysis of the Numerical Pain Rating Scale for the both treatment groups showed improvement. Group 1 had a 92.44% improvement and group 2 had a 93.18% improvement. No statistically significant..