Effects of Electro Dry Needling Versus Dry Needling in Levator Scapulae Syndrome

Effects of Electro Dry Needling Versus Dry Needling on Pain, Muscle Strength, and Range of Motion in Patients With Levator Scapulae Syndrome

Mechanical neck pain is posteriorly occurring non-specific pain that originates from the superior nuchal line and extends to the first thoracic vertebrae. It is exacerbated by sustained neck postures, neck movements or cervical muscle palpation. The aim of study will be to compare the effects of Electro Dry Needling and Dry Needling on pain, muscle strength, disability and range of motion in patients with Levator Scapulae Syndrome.

A Randomized Clinical Trial will be conducted at Shalamar Hospital, (SIHS Physiotherapy Clinic Lahore) through convenience sampling technique on 30 patients which will be allocated using simple random sampling through sealed opaque enveloped into Group A and Group B. Group A will receive Electro Dry Needling along with conventional physiotherapy in which parameters for Electro dry needling will be needles of 30×0.25 mm, 50×0.25 mm sizes, Frequency 80-100 Hz, Duration 10-20 minutes and intensity as tolerated and Group B will receive Dry Needling along with conventional Physiotherapy in which parameters will be dry needles will be 30×0.25 and 50×0.25 mm sizes. Standard Physiotherapy will include a Hot pack (10 min), Stretching of levator scapulae (3 times with 30 second hold), and Scapular stabilization exercises (10 times with 5 second hold).There will be 3 sessions per week, Needling in both groups will be for performed 2 times per week for total 3rd week of treatment comprising of 6 sessions, 3rd session will comprise of standard physical therapy. Pre and Post treatment measures will be recorded.Outcome measures will be conducted through pain, *muscle strength,* disability and range of motion questionnaire. Data will be analyzed during *SPSS software version 25.After assessing the normality of data by the Shapiro-Wilk test, it will be decided whether a parametric or non-parametric test will be used within a group or between two groups.

Inclusion Criteria:

• Age ranges of 18-45 years
• Both genders, males and females
• Positive Levator Scapular length Test (7)
• Positive Simon's criteria for Levator scapulae
• Neck pain -NPRS < 7 (8)
• Neck and upper back pain for at least 3months.
• Examination - Increased muscle tone and tenderness at neck and upper back
• Reduced ROM-Side flexion and Rotation of neck
• Non traumatic unilateral mechanical neck pain of three or more months of duration, presenting an latent MTrP in the levator scapulae muscle on the painful side

Exclusion Criteria:

• Neuropathies
• Radiated pain towards the arm
• Vertebral fractures
• Traumatic neck injury
• whiplash injury (9)
• previous surgical procedures in the cervical spine
• Previous cognitive and functional disorders
• psychological disorders (mood and psychotic disorders such as schizophrenia, depression,and anxiety disorders),
• Fibromyalgia