Comparison of pressure release, phonophoresis and dry needling in treatment of latent myofascial trigger point of upper trapezius muscle

J Back Musculoskelet Rehabil. 2019;32(4):587-594. doi: 10.3233/BMR-181302.


Background: Latent myofascial trigger point (LMTP) is a small hypersensitive area in skeletal muscles that becomes painful under compression or stimulation. LMTPs are relevant for various musculoskeletal disorders. Although several treatments have been introduced to treat LMTP, the most efficient one is yet to be found.

Objective: The main purpose of the present study was to compare pressure release, phonophoresis of betamethasone and dry needling on the upper trapezius latent myofascial trigger point.

Methods: Sixty participants (mean ± SD age, 23.6 ± 2.1 y), with at least one latent myofascial trigger point in the upper trapezius muscle, participated in this study. Subjects were randomly divided into three groups (pressure release, phonophoresis with betamethasone and dry needling groups) for two weeks. Pain intensity, pain pressure threshold and active cervical range of motion were assessed.

Results: Significant pain decrease, active cervical range of motion and pain pressure threshold increase were observed in the three groups (p< 0.001). The dry needling and phonophoresis groups reported more significant improvement compared to the pressure release group (p< 0.001). There was no difference between the dry needling and phonophoresis groups.

Conclusions: Considering the significant, positive effects of all three methods, dry needling and phonophoresis seem to be more effective than pressure release.

Keywords: Trigger point; betamethasone; needles; phonophoresis; trapezius muscle.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anti-Inflammatory Agents / administration & dosage
  • Betamethasone / administration & dosage
  • Dry Needling*
  • Humans
  • Male
  • Myofascial Pain Syndromes / therapy*
  • Pain
  • Pain Measurement
  • Pain Threshold
  • Phonophoresis*
  • Pressure
  • Range of Motion, Articular
  • Superficial Back Muscles*
  • Trigger Points*
  • Young Adult


  • Anti-Inflammatory Agents
  • Betamethasone