Controlled intervention to compare the efficacies of manual pressure release and the muscle energy technique for treating mechanical neck pain due to upper trapezius trigger points

J Pain Res. 2018 Dec 12:11:3151-3160. doi: 10.2147/JPR.S172711. eCollection 2018.


Purpose: This study aimed at comparing the clinical efficacies of two manual therapies to determine the most beneficial result-oriented physiotherapeutic approach for treating nonspecific neck pain due to myofascial trigger points (MTrPs).

Methods: This was a randomized, controlled pretest-posttest experimental study that compared manual pressure release (MPR), the muscle energy technique (MET), and a control condition. These techniques were compared using a convenience sample of 45 female participants with neck pain due to MTrPs (mean age±SD=21.49±3.66; age range=18-30 years). The visual analog scale, pressure pain threshold, Neck Disability Index Questionnaire, and a standardized measuring tape were used to assess the participants' neck pain, muscle tenderness, functional disability due to neck pain, and range of neck rotation, respectively, at baseline (day 0), day 1, and day 5 postintervention and at days 10 and 15 during follow-up. All groups were given postural advice and at-home neck exercises. Repeated-measures ANOVA and one-way ANOVA were used to analyze the data.

Results: The within-group analyses showed significant improvement (P<0.05) in all outcome measures at days 1 and 5 postintervention and at days 10 and 15 during the follow-up for all groups. The between-group analyses confirmed nonsignificant differences (P>0.05) between all groups for all variables.

Conclusion: MPR and the MET are equally effective for reducing pain and muscle tenderness and for improving neck disability and range of rotation in patients with nonspecific neck pain. Furthermore, advice promoting postural correction can be an adjunct to physiotherapeutic interventions for reducing neck pain and its symptoms. A combination of these manual therapies with postural advice might be a good treatment option for nonspecific pain in physiotherapy clinics.

Keywords: manual pressure release; muscle energy technique; neck pain.