Combined Therapy and Jones Technique for Upper Trapezius Myofascial Trigger Points

NCT07695402 | Completed

• 1 other identifier: 7.119.287
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Myofascial trigger points in the upper trapezius muscle are a common cause of neck pain and may negatively affect pressure pain threshold, upper limb function, sleep quality, and quality of life. This randomized, sham-controlled clinical trial aimed to compare the effects of the Jones Technique, combined therapy (therapeutic ultrasound plus transcutaneous electrical nerve stimulation \[TENS\]), their combination, and a sham intervention in women with active upper trapezius myofascial trigger points. The primary outcome was pressure pain threshold. Secondary outcomes included pain intensity, upper limb disability, sleep quality, quality of life, physical activity level, and participant satisfaction.

Conditions

Neck Pain Musculoskeletal; Myofascial Trigger Points; Myofascial Pain Syndrome - Neck

Keywords

Upper Trapezius; Jones Technique; Strain Counterstrain; Therapeutic Ultrasound; Transcutaneous Electrical Nerve Stimulation

Outcome Measures

Primary Outcomes (2)

• Pressure Pain Threshold (PPT)

  Pressure pain threshold assessed using a pressure algometer at five active myofascial trigger points in the upper trapezius muscle. The pressure pain threshold is recorded in kg/cm². Higher values indicate greater pressure tolerance and therefore a better outcome.

  Baseline and immediately after the intervention (single treatment session)

• Pain Intensity

  Pain intensity assessed using the Visual Analog Scale for Pain (VAS). Scores range from 0 to 10 cm, where 0 indicates no pain and 10 indicates the worst pain imaginable. Higher scores indicate worse pain.

  Baseline and immediately after the intervention

Secondary Outcomes (5)

• Upper Limb Disability

  Baseline

• Sleep Quality

  Baseline

• Quality of life

  Baseline

• Physical Activity Level

  Baseline

• Participant Satisfaction

  Immediately after the intervention

Study Arms (4)

Jones Technique

EXPERIMENTAL

Participants received a single session of the Jones Technique for the treatment of active myofascial trigger points in the upper trapezius muscle.

Procedure: Jones Technique

Combined Therapy

EXPERIMENTAL

Participants received a single session of combined therapy consisting of therapeutic ultrasound combined with transcutaneous electrical nerve stimulation (TENS) applied to active myofascial trigger points in the upper trapezius muscle.

Device: Combined Therapy (Therapeutic Ultrasound + TENS)

Combined Therapy + Jones Technique

EXPERIMENTAL

Participants received the Jones Technique followed immediately by combined therapy (therapeutic ultrasound plus transcutaneous electrical nerve stimulation \[TENS\]) during a single treatment session.

Combination Product: Combined Therapy + Jones Technique

Sham Control

SHAM COMPARATOR

Participants underwent all study assessments and received sham treatment consisting of inactive combined therapy (device turned off) and a simulated Jones Technique without therapeutic pressure.

Procedure: Sham Intervention

Interventions

Jones Technique PROCEDURE

Manual therapy technique applied to active myofascial trigger points of the upper trapezius muscle. Participants were positioned in prone lying, and sustained pressure with positional release was applied to each trigger point for 90 seconds. Five trigger points were treated during a single treatment session.

Jones Technique

Combined Therapy + Jones Technique COMBINATION_PRODUCT

Participants received the Jones Technique followed immediately by combined therapy (therapeutic ultrasound plus transcutaneous electrical nerve stimulation \[TENS\]) during a single treatment session.

Combined Therapy + Jones Technique

Sham Intervention PROCEDURE

Participants underwent sham treatment consisting of inactive combined therapy with the device turned off and a simulated Jones Technique performed without therapeutic pressure.

Sham Control

Combined Therapy (Therapeutic Ultrasound + TENS) DEVICE

Combined therapy consisting of pulsed therapeutic ultrasound (1 MHz, 20% duty cycle, 1.0 W/cm²) delivered simultaneously with transcutaneous electrical nerve stimulation (TENS; biphasic asymmetric waveform, 200 μs pulse duration, 100 Hz). Treatment was applied to five active upper trapezius myofascial trigger points during a single 10-minute session.

Combined Therapy

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Female participants aged 18 to 40 years.
• Presence of active myofascial trigger points in the upper trapezius muscle for no longer than 12 weeks.
• Neck pain lasting less than 3 months.
• Pain intensity of at least 3 cm on the 10-cm Visual Analog Scale (VAS).
• Ability to understand the study procedures and provide written informed consent.

You may not qualify if:

• Presence of a cardiac pacemaker or other contraindications to electrotherapy.
• Pregnancy.
• Uncontrolled cardiovascular disease.
• Psychiatric disorders that could interfere with study participation.
• Thrombosis or coagulation disorders.
• History of tumors or neoplasms.
• Physical therapy or myofascial treatment within the previous 3 weeks.
• Treatment for myofascial trigger points within the previous 3 months.
• Current use of analgesic medications.
• Cervical musculoskeletal disorders (e.g., cervical osteoarthritis or other cervical lesions).
• History of cervical trauma or surgery.
• Cervical spondylosis or spondylolisthesis with radiculopathy.
• Fibromyalgia or other systemic rheumatic diseases.
• Other musculoskeletal disorders that could interfere with the study outcomes.

Sponsors & Collaborators

• Isabel de Almeida Paz: lead

Study Sites (1)

Physical Therapy Teaching Clinic, Universidade do Vale do Rio dos Sinos (UNISINOS)

São Leopoldo, Rio Grande do Sul, Brazil

Location

MeSH Terms

Interventions

Ultrasonic Therapy; Transcutaneous Electric Nerve Stimulation; Psychotherapy, Multiple

Intervention Hierarchy (Ancestors)

Diathermy; Hyperthermia, Induced; Therapeutics; Electric Stimulation Therapy; Physical Therapy Modalities; Rehabilitation; Analgesia; Anesthesia and Analgesia; Psychotherapy; Behavioral Disciplines and Activities

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: July 4, 2026
• First Posted: July 10, 2026
• Study Start: October 7, 2024
• Primary Completion: October 20, 2024
• Study Completion: December 20, 2024
• Last Updated: July 14, 2026

Record last verified: 2026-07

Locations

BR (1)