Myofascial Trigger PointsMETvsSORNCT07868497
Comparison of Suboccipital Release and Muscle Energy Technique in Subjects With Mechanical Neck Pain and Forward Head Posture
A study testing Spray and Stretch Technique, Sustained Pressure Technique and Conventional Physiotherapy in people with Myofascial Trigger Points and Neck Pain, run by King Edward Medical University at 1 site in Pakistan.
Trial summary
This study will compare two physiotherapy treatments for adults with long-lasting neck pain and tender muscle spots, called trigger points, in the upper trapezius muscle between the neck and shoulder. Read more about this study
- Who is it for?
- Ages 20 to 30 years
- Conditions the study is for
- Myofascial Trigger Points, Neck Pain
- What is being tested?
- Spray and Stretch Technique, Sustained Pressure Technique and Conventional Physiotherapy
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 76 participants
- Where
- 1 sitePakistan
- Study dates
- 10 Oct 2026to 30 Dec 2026
- Phase
- Interventional
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 20 to 30 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Chronic mechanical neck pain lasting at least three months.
- At least one upper trapezius trigger point with painful restriction of cervical range of motion.
- Forward head posture.
- Pain intensity below 7 on the 0-10 Visual Analogue Scale. -
Who cannot join
- Previous cervical spine surgery.
- Thoracic outlet syndrome.
- Cervical radiculopathy.
- Skin infection or open wounds in the cervical region.
- Cervical tumour.
- Cervical spine fracture.
- Use of steroid therapy.
- -
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Annusha Arshad, DPT contact
About this study
Official title: Comparative Effectiveness of Suboccipital Release and Muscle Energy Technique to Reduce Pain and Improve Craniovertebral Angle, Cervical Range of Motion and Neck Functional Ability in Subjects With Mechanical Neck Pain and Forward Head Posture
This study will compare two physiotherapy treatments for adults with long-lasting neck pain and tender muscle spots, called trigger points, in the upper trapezius muscle between the neck and shoulder. The aim is to find out which treatment was more effective in reducing pain, improving neck movement, and reducing difficulty with daily activities.
The study will includ 76 adults aged 20-40 years at Mayo Hospital, Lahore, Pakistan. Participants will be assigned by chance to one of two treatment groups. One group will receive a cooling spray followed by gentle stretching of the affected muscle. The other group will receive sustained pressure applied by a therapist to the tender muscle spots. Both groups also will receive routine physiotherapy, including heat, exercises, and advice about neck care and posture.
Participants will receive six treatment sessions over two weeks. Pain, neck movement, and difficulty with daily activities will be assessed before treatment, immediately after the first session, and after the sixth session.
Read the detailed description
Mechanical neck pain may be accompanied by upper trapezius trigger points, which are tender muscle spots associated with pain and restricted movement. Spray-and-stretch and sustained-pressure techniques are used to manage these symptoms, but their comparative short-term effects remain uncertain.
This study will evaluate the additional effects of each technique when combined with the same conventional physiotherapy programme. The comparison will examine both the immediate response to the first treatment session and the response after completion of the two week programme. It will focuse on whether differences between the treatments will be observed across pain, cervical mobility, and neck-related disability.
- Conditions
- Myofascial Trigger Points, Neck Pain
- Being tested
- Spray and Stretch Technique, Sustained Pressure Technique, Conventional Physiotherapy
- Keywords
- Chronic Neck Pain, Upper Trapezius, Spray and Stretch Technique, Sustained Pressure Technique, Ischemic Compression, Cervical Range of Motion, Neck Disability, Physiotherapy
- Medical subject headings
- Neck Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Spray and Stretch TechniqueOther
With the participant seated comfortably, a vapocoolant spray will be applied in 3-5 parallel sweeps over the upper trapezius muscle, followed by stretching of the affected muscle. The procedure will be repeated 2-3 times per session. Participants will receive six sessions, three times weekly for two weeks, alongside conventional physiotherapy.
Sustained Pressure TechniqueOther
Also called Sustained Compression, Ischemic Compression
The therapist will apply sustained manual pressure to upper trapezius trigger points, adjusting the pressure according to the participant's tolerance. Pressure application will be repeated during each session. Participants will receive six sessions, three times weekly for two weeks, alongside conventional physiotherapy.
Conventional PhysiotherapyOther
Both groups will receive a hot pack over the upper trapezius for 10 minutes, cervical isometric exercises, active neck movement exercises, shoulder shrugs, retraction exercises, and advice on posture and neck care. Exercises will be progressed during the second week. Conventional physiotherapy will provide during six sessions, three times weekly for two weeks.
| Study group | Role | What they receive |
|---|---|---|
| Spray-and-Stretch Plus Conventional Physiotherapy | Experimental | Participants received spray-and-stretch treatment targeting upper trapezius trigger points, alongside conventional physiotherapy. A vapocoolant spray will be applied over the affected muscle, followed by stretching. Conventional physiotherapy will include a hot pack, neck isometric and movement exercises, shoulder shrugs, retraction exercises, and neck-care and posture advice. Treatment will consist of six sessions, three times weekly for two weeks. Receives: Other: Spray and Stretch Technique; Other: Conventional Physiotherapy |
| Sustained Pressure Plus Conventional Physiotherapy | Active comparator | Participants will receive sustained pressure applied by a therapist to upper trapezius trigger points, alongside conventional physiotherapy. Conventional physiotherapy will include a hot pack, neck isometric and movement exercises, shoulder shrugs, retraction exercises, and neck-care and posture advice. Treatment will consist of six sessions, three times weekly for two weeks. Receives: Other: Sustained Pressure Technique; Other: Conventional Physiotherapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pain intensity
Pain Intensity Measured Using the Visual Analogue Scale
Measured: Baseline, immediately after the first treatment session, and after the sixth treatment session (2 weeks).
Cervical range of motion
Active cervical range of motion will be measured in degrees using a goniometer. Measurements included flexion, extension, right and left lateral flexion, and right and left rotation. Higher values indicate greater range of motion.
Measured: Baseline, immediately after the first treatment session, and after the sixth treatment session (2 weeks).
Neck Related Disability Measured Using the Neck Disability Index
The Neck Disability Index assesses the effect of neck pain on daily activities through 10 items, each scored from 0 to 5. The total raw score ranges from 0 to 50, with higher scores indicating greater disability.
Measured: Baseline, immediately after the first treatment session, and after the sixth treatment session (2 weeks)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Oct 2026
- Study start10 Oct 2026 (estimated)
- Primary completion15 Dec 2026 (estimated)
- Study completion30 Dec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Myofascial Trigger PointsStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants will be randomly allocated by lottery to two parallel groups, with 38 participants in each group. One group will receive spray-and-stretch plus conventional physiotherapy, while the other will receive sustained pressure plus conventional physiotherapy. Both groups will receive six sessions over two weeks.
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 76 participants (estimated)
Sponsor and investigators
- Lead sponsor
- King Edward Medical University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Amna Zia, King Edward Medical University
- Investigators
- Amna Zia, PhD. Scholar, Principal investigator, King Edward Medical University, LahoreAnnusha Arshad, Principal investigator, King Edward Medical University, Lahore
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07868497
- Sponsor's protocol ID
- 866/RC/KEMU
- Acronym
- METvsSOR
- Status last verified
- Mar 2026
- First submitted
- 5 Oct 2026
- Last updated
- 9 Oct 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: There is no plan to share individual participant data with other researchers. Aggregate findings will be reported in publications.