INSTRUMENT ASSISSTED SOFT TISSUE MOBILIZATION VERSUS DRY CUPPING ON UPPER TRAPEZIUS TRIGGER POINTS: A RANDOMIZED CONTROLLED TRIAL

NCT07260019 | Not Yet Recruiting

• 1 other identifier: P.T.REC/012/006052
• Study Type: interventional
• Target: 75
• Locations: 0 countries
• Sites: N/A

Brief Summary

The goal of this randomized controlled trial is to compare the effects of Instrument Assisted Soft Tissue Mobilization (IASTM) and dry cupping in patients (both genders), aged 20-50 years, diagnosed with chronic non-specific neck pain who have active upper trapezius trigger points. The main questions it aims to answer are :

1. 1.Is there a significant difference in the effect on pain level (measured by VAS) between the groups?
2. 2.Is there a significant difference in the effect on cervical range of motion (CROM), pressure pain threshold (PPT), and functional disability (NDI) between the groups?
3. 3.Group A (Control):\] Will receive a conventional physical therapy program (hot packs, TENS, and exercises).
4. 4.Group B (Experimental):\] Will receive conventional therapy plus IASTM.
5. 5.Group C (Experimental):\] Will receive conventional therapy plus Dry Cupping.
6. 6.Undergo baseline assessments (measuring pain, ROM, PPT, and disability) before treatment and final assessments after 4 weeks.
7. 7.Attend \[3 treatment sessions per week for four weeks\].
8. 8.At each session, all participants will receive the conventional physical therapy program , while Groups B and C will receive their additional intervention (IASTM or dry cupping).

Conditions

Upper Trapezius Trigger Points; Non Specific Chronic Neck Pain

Keywords

IASTM; DRY CUPPING; UPPER TRAPEZIUS TRIGGER POINTS

Outcome Measures

Primary Outcomes (1)

• Pain Intensity Level

  Pain intensity will be assessed using the Visual Analogue Scale (VAS). The VAS is a self-reported 10 cm line where 0 cm represents "no pain" and 10 cm represents "worst imaginable pain".

  Baseline (before intervention) and after 4 weeks of treatment.

Secondary Outcomes (3)

• Cervical Range of Motion (CROM)

  Baseline (before intervention) and after 4 weeks of treatment.

• Pressure Pain Threshold (PPT)

  Baseline (before intervention) and after 4 weeks of treatment.

• Functional Disability

  Baseline (before intervention) and after the 4-week intervention period.

Study Arms (3)

Group A (Control Group)

ACTIVE COMPARATOR

Participants will receive a conventional physical therapy program. This includes hot packs applied over the neck and upper shoulders for 15-20 minutes , Transcutaneous Electrical Nerve Stimulation (TENS) applied for 20-30 minutes , and a supervised exercise program (including range of motion, isometric strengthening, chin tucks, and scapular retractions). The treatment will be administered for 3 sessions per week for four weeks.

Other: Hot Packs; Device: Transcutaneous Electrical Nerve Stimulation; Behavioral: Exercise Program

Group B (IASTM Group)

EXPERIMENTAL

Participants will receive the same conventional physical therapy program as Group A (hot packs, TENS, and exercises) . In addition, they will receive Instrument Assisted Soft Tissue Mobilization (IASTM). This combined treatment will be administered for 3 sessions per week for four weeks.

Device: Instrument Assisted Soft Tissue Mobilization; Other: Hot Packs; Device: Transcutaneous Electrical Nerve Stimulation; Behavioral: Exercise Program

Group C (Dry Cupping Group)

EXPERIMENTAL

Participants will receive the same conventional physical therapy program as Group A (hot packs, TENS, and exercises) . In addition, they will receive Dry Cupping. This combined treatment will be administered for 3 sessions per week for four weeks.

Device: Dry Cupping; Other: Hot Packs; Device: Transcutaneous Electrical Nerve Stimulation; Behavioral: Exercise Program

Interventions

Instrument Assisted Soft Tissue Mobilization DEVICE

While the participant is seated, a lubricant (Vaseline) is applied to the skin. The M2T blade is used at a 45° angle to apply slow sweeping strokes along the muscle from origin to insertion (sweeping technique) over the upper trapezius for approximately three minutes.

Also known as: IASTM , M2T Blade

Group B (IASTM Group)

Dry Cupping DEVICE

While the participant is in a prone position , a single 5cm inner diameter plastic cup is applied to the skin directly over the pre-determined treatment location. The cup is secured by pumping a manual hand-pump three times. The cup is left in place for 5 minutes.

Group C (Dry Cupping Group)

Hot Packs OTHER

Commercially accessible hot packs (made of bentonite) are placed over the neck and the upper part of the shoulder musculature while the patient is in a prone position. The application lasts for 15-20 minutes.

Group A (Control Group); Group B (IASTM Group); Group C (Dry Cupping Group)

Transcutaneous Electrical Nerve Stimulation DEVICE

Applied while the patient is sitting. Electrodes are placed directly over or surrounding the trigger point and along the muscle belly. Parameters: Pulse rate 60-100Hz , Pulse width 40-250 μs. Intensity is set to a tolerable tingling sensation. Treatment duration is 20-30 minutes.

Also known as: TENS

Group A (Control Group); Group B (IASTM Group); Group C (Dry Cupping Group)

Exercise Program BEHAVIORAL

A supervised home exercise program consisting of: Range of Motion Exercises: Cervical flexion, extension, lateral flexion, rotation, and shoulder shrugs. Strengthening Exercises: Isometric cervical flexion, extension, lateral flexion, and rotation; scapular retractions; and chin tucks. Dosage: Performed daily for 10-15 repetitions and 2-3 sets

Group A (Control Group); Group B (IASTM Group); Group C (Dry Cupping Group)

Eligibility Criteria

• Age: 20 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Participants aged 20 to 50.
• Diagnosis of chronic non-specific neck pain (\> 4 weeks duration).
• Had an active upper trapezius TrP (defined as a tender nodule in a taut band that referred pain in a pattern specific for upper trapezius TrP1 or TrP2).
• Pain of at least 40 mm on a visual analogue scale (VAS).
• Body mass index from 18 - 30 kg/m2

You may not qualify if:

• Participants who will exhibit signs of fibromyalgia syndrome.
• Participants with a specific neck pain such as cervical radiculopathy with neurological deficits (e.g., motor weakness, significant sensory loss), cervical instability, fracture, tumor, infection, or inflammatory arthropathies.
• Sensory problems in the upper or midback regions, heart/circulation problems.
• Participants who will have vascular syndromes such as vertebrobasilar insufficiency.
• Participants with skin lesions, fragile skin, or a history of bleeding disorders.

Sponsors & Collaborators

• Cairo University: lead

MeSH Terms

Interventions

Transcutaneous Electric Nerve Stimulation; Resistance Training

Intervention Hierarchy (Ancestors)

Electric Stimulation Therapy; Therapeutics; Physical Therapy Modalities; Rehabilitation; Analgesia; Anesthesia and Analgesia; Exercise Therapy; Aftercare; Continuity of Patient Care; Patient Care; Physical Conditioning, Human; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• IBRAHIM H MADY, Bsc

  Cairo University

  PRINCIPAL INVESTIGATOR

• Fatma Seddik, Prof.Dr

  Basic Science Department, Faculty Of Physical Therapy, Cairo University

  STUDY DIRECTOR

• Ahmed Said, Dr

  Basic Science Department, Faculty Of Physical Therapy, Cairo University

  STUDY DIRECTOR

Central Study Contacts

IBRAHIM H MADY, BSc

CONTACT

+201556822721; ibrahimmady47@gmail.com

Fatma Seddik, Prof. Dr.

CONTACT

+201223417697

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The study is described as a "single blinded randomized controlled trial". Given the distinct physical nature of the interventions (IASTM vs. Dry Cupping), it is not feasible to blind the participants or the care providers. Blinding will be applied to the Outcomes Assessor, who will perform the outcome measurements without knowledge of the participant's group assignment to prevent bias.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: November 21, 2025
• First Posted: December 2, 2025
• Study Start: December 1, 2025
• Primary Completion (Estimated): November 1, 2026
• Study Completion (Estimated): December 1, 2026
• Last Updated: December 2, 2025

Record last verified: 2025-11