This study compares dry needling and manual trigger point release for treating active rhomboid trigger points in 48 patients, assessing pain, ROM, and function. It addresses a gap in evidence for optimal pain management in upper back myofascial pain. Findings will guide clinical practice for more effective, evidence-based interventions.

This randomized controlled trial (RCT) investigates the effectiveness of dry needling versus manual trigger point release in treating active rhomboid trigger points. The study aims to compare the effect of two interventions on pain, range of motion (ROM), and functional outcomes in patients with rhomboid muscle pain.

Participants: 48 individuals (aged 20-60) with clinically confirmed active rhomboid trigger points.

Interventions:

Group 1: Dry needling therapy.

Group 2: Manual trigger point release. Both groups receive adjunct therapies (ultrasound, cold packs, and home exercises).

Outcome Measures: Pain (Numeric Pain Rating Scale), ROM (goniometer), and function (DASH Questionnaire).

Duration: 2-week intervention with follow-ups at 1 and 2 weeks.

Significance: The study addresses a gap in evidence for rhomboid trigger point treatments, guiding clinical decisions for pain management. Results may optimize therapeutic approaches for upper back pain.

Inclusion Criteria:

• Presence of a clinically confirmed active trigger point in the rhomboid muscle based on established criteria (e.g., palpable tight band, local tenderness, referred pain pattern).
• Pain Level: Moderate to severe pain intensity (e.g., 4 or higher on a Visual Analog Scale or Numeric Pain Rating Scale).
• Duration of Symptoms: pain for at least 4 weeks.

Exclusion Criteria:

• Patient with conditions that may contribute to neck and subscapular pain other than rhomboid:
• fibromyalgia
• Rheumatic and inflammatory disease
• Recent Surgery
• Diabatic
• Cervical radiculopathy and nerve entrapment
• Pregnancy
• Malignancy