IMPACT OF DRY NEEDLING WITH MYOFASCIAL RELEASE; A SYNERGISTIC APPROACH FOR PAIN, MOBILITY AND DYNAMIC BALANCE IN CERVICAL MYOFASCIAL PAIN SYNDROME: A RANDOMIZED CONTROLLED TRIAL

NASIR MEHMOOD, SURIYAKALA PERUMAL CHANDRAN, WAQAS AHMED, MAZHAR ALI BHUTTO, MAHTAB AHMED MUKHTAR PATAFI, MUHAMMAD SHAHZAIB ALAM, MUHAMMAD ASIF, SHAFIA ARSHAD

Background: Cervical myofascial pain syndrome (MPS) causes severe pain, impairs range of motion (ROM), and dynamic balance.

Objective: Compare impact of Dry Needling combined with Myofascial Release (DN+MFR) versus Conventional Physiotherapy cervical pain, range of motion (ROM) and dynamic balance among patients diagnosed with cervical myofascial pain syndrome (MPS).

Methods: A two-arm randomized controlled trial (N = 50; 25 per group) was conducted over 4 weeks, with assessments at pre-, mid-, and post-intervention stages. Group A (Interventional group) received Dry Needling with Myofascial Release while Group B (Control group) received conventional physiotherapy management of MPS; which comprised of TENS, Therapeutic Ultrasound and ROM exercises. Outcomes included pain (NPRS), dynamic balance (Y-Balance Test), and cervical ROM (CROM Deluxe). Data were analyzed using GLM repeated-measures ANOVA with sphericity checks and Greenhouse–Geisser corrections applied where necessary.

Results: Large time effects for all outcomes (p<.001; η²= .91–.97). There were marked Time×Group interactions favoring DN+MFR for pain (F(1.90,91.22)=136.84, p<.001, η²=.740) and for ROM; flexion (F(1.75,84.02)=137.46, p<.001, η²=.741), extension (F(2,96)=133.26, p<.001, η²=.735), rotation left (F(1.74,83.43)=130.40, p<.001, η²=.731), and rotation right (F(1.75,83.84)=143.27, p<.001, η²=.749). Post means (±SE): NPRS DN+MFR 0.48±0.16 vs Control 5.64±0.16. Between-group effects also favored DN+MFR for pain and several ROM planes (all p<.001). Y-Balance improved strongly over time in both groups; Left composite showed no interaction (p=.864) and no between-group difference (p=.107), while Right composite showed a small interaction (F(1.25,59.99)=5.37, p=.017, η²=.101) with higher Post means in DN+MFR.

Conclusion: Dry Needling combined with Myofascial Release produced substantially greater pain reduction and ROM gains than conventional physiotherapy; balance improved in both groups, with only modest between-group differences.