Effectiveness of Dry Needling on Reducing Pain, Increasing Range of Motion of the Neck, and Increasing Craniovertebral Angle in Obese Patients with Cervical Myofascial Pain Syndrome
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Published:
Jun 17, 2025
Keywords:
Dry Needling, Obesity, Pain, Range of Motion in the Joint, Craniovertebral Angle, Myofascial Neck Pain Syndrome
Main Article Content
Abstract
Introduction: Obese patients often experience neck pain due to cervical myofascial pain syndrome.Dry needling is one of method to treat myofascial pain syndrome.
Methods: This study was a single-blind randomized controlled trial. Participants aged 18- 59 year with neck pain > 3 months caused by myofascial pain syndrome in the neck region. Patients were randomized into the dry needling group (n=16 subjects) and the control group (n=16 subjects). The dry needling group received dry needling therapy once a week for 4 weeks and exercise therapy three times a week for 4 weeks. The control group received exercise therapy only three times a week for 4 weeks.
Results: Participants had an average age of 41.4±11.2 years. Both groups experienced significant improvement in NRS, cervical ROM, and CVA between the pre-treatment assessment and the fourth week evaluation (p<0.05). The dry needling group experienced more significant improvements in NRS, cervical extension ROM, and CVA compared to the control group at the fourth week evaluation (p<0.05).
Conclusion: Dry needling combined with exercise or exercise therapy alone is effective in improving NRS, cervical ROM, and CVA in obese patients with cervical myofascial pain syndrome. However, dry needling combine with exercise therapy is superior to exercise therapy alone.
Keywords : Dry Needling, Obesity, Pain, Range of Motion in the Joint, Craniovertebral Angle, Myofascial Neck Pain Syndrome
Methods: This study was a single-blind randomized controlled trial. Participants aged 18- 59 year with neck pain > 3 months caused by myofascial pain syndrome in the neck region. Patients were randomized into the dry needling group (n=16 subjects) and the control group (n=16 subjects). The dry needling group received dry needling therapy once a week for 4 weeks and exercise therapy three times a week for 4 weeks. The control group received exercise therapy only three times a week for 4 weeks.
Results: Participants had an average age of 41.4±11.2 years. Both groups experienced significant improvement in NRS, cervical ROM, and CVA between the pre-treatment assessment and the fourth week evaluation (p<0.05). The dry needling group experienced more significant improvements in NRS, cervical extension ROM, and CVA compared to the control group at the fourth week evaluation (p<0.05).
Conclusion: Dry needling combined with exercise or exercise therapy alone is effective in improving NRS, cervical ROM, and CVA in obese patients with cervical myofascial pain syndrome. However, dry needling combine with exercise therapy is superior to exercise therapy alone.
Keywords : Dry Needling, Obesity, Pain, Range of Motion in the Joint, Craniovertebral Angle, Myofascial Neck Pain Syndrome
Article Details
How to Cite
Tamin, T. Z., Mukti Ali Mukhtar, Anestherita, F., Kusumaningsih, W., & Vidiawati, D. (2025). Effectiveness of Dry Needling on Reducing Pain, Increasing Range of Motion of the Neck, and Increasing Craniovertebral Angle in Obese Patients with Cervical Myofascial Pain Syndrome. Indonesian Journal of Physical Medicine and Rehabilitation, 14(1), 14 - 28. https://doi.org/10.36803/indojpmr.v14i1.435
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Original Article
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15. Agung I, Murdana N, Purba H. The Relationship Between The Body Mass Index and The
Pain Threshold in Myofascial Pain Syndrome: A Cross-sectional Study. Indonesian Journal
of Physical Medicine and Rehabilitation. 2017;6(01):8–17.
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Fernández-De-Las-peñas C. Short-term changes in neck pain, widespread pressure pain
sensitivity, and cervical range of motion after the application of trigger point dry needling in
15
patients with acute mechanical neck pain: a randomized clinical trial. Journal of orthopaedic
& sports physical therapy. 2014;44(4):252–60.
18. Aydın T, Dernek B, Sentürk Ege T, Karan A, Aksoy C. The effectiveness of dry needling
and exercise therapy in patients with dizziness caused by cervical myofascial pain
syndrome; prospective randomized clinical study. Pain Medicine. 2019;20(1):153–60.
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21. Sheikhhoseini R, Shahrbanian S, Sayyadi P, O’Sullivan K. Effectiveness of therapeutic
exercise on forward head posture: a systematic review and meta-analysis. J Manipulative
Physiol Ther. 2018;41(6):530–9.
Merino D, Sánchez-Sánchez B. Health related quality of life improvement in chronic non-
specific neck pain: secondary analysis from a single blinded, randomized clinical trial.
Health Qual Life Outcomes. 2018;16:1–10.
2. WHO. Obesity and overweight. world Health Organization. 2024.
3. Muñoz-Muñoz S, Muñoz-García MT, Alburquerque-Sendín F, Arroyo-Morales M,
Fernández-de-las-Peñas C. Myofascial trigger points, pain, disability, and sleep quality in
individuals with mechanical neck pain. J Manipulative Physiol Ther. 2012;35(8):608–13.
4. Kim DH, Kim CJ, Son SM. Neck pain in adults with forward head posture: effects of
craniovertebral angle and cervical range of motion. Osong Public Health Res Perspect.
2018;9(6):309.
5. Elhafez HM, Mahmoud MA. Effect of body mass index on craniovertebral angle and
shoulder angle in Egyptian adolescents. Egyptian Journal of Physical Therapy.
2020;1(1):14–7.
6. Mahmoud NF, Hassan KA, Abdelmajeed SF, Moustafa IM, Silva AG. The relationship
between forward head posture and neck pain: a systematic review and meta-analysis. Curr
Rev Musculoskelet Med. 2019;12(4):562–77.
7. Fernández‐de‐las‐Peñas C, Cuadrado ML, Pareja JA. Myofascial trigger points, neck
mobility, and forward head posture in episodic tension‐type headache. Headache: The
Journal of Head and Face Pain. 2007;47(5):662–72.
8. Travell JG, Simons DG. Myofascial pain and dysfunction: the trigger point manual. Vol. 2.
Lippincott Williams & Wilkins; 2019.
9. Fernández-de-las-Peñas C. Trigger point dry needling: an evidence and clinical-based
approach. Churchill Livingstone; 2013.
10. Agung I, Murdana N, Purba H, Fuady A. Low-level laser therapy and dry needling for
myofascial pain syndrome of the upper trapezius muscle: An interventional study. In:
Journal of Physics: Conference Series. IOP Publishing; 2018. p. 062045.
11. Iaroshevskyi OA, Morozova OG, Logvinenko A V, Lypynska Y V. Non-pharmacological
treatment of chronic neck-shoulder myofascial pain in patients with forward head posture.
Wiad Lek. 2019;72(1):84–8.
12. Budianto P, Kirana DH, Hafizhan M, Putra SE, Mirawati DK, Prabaningtyas HR. The effect
of duration gadget uses during COVID-19 pandemic on neck pain, neck disability, and sleep
quality. Int J Publ Health Sci. 2022;11(2):581–8.
13. HAMID NA, RASHID SM, ISHAK MS, WULAN RR. Effects of social media usage: The
well-being and flourishing of housewives. Jurnal Komunikasi: Malaysian Journal of
Communiation. 2022;38(1):284–304.
14. Saeed R, Noor R, Bashir MS. Work related Neck disability due to active myofascial trigger
points (MTrPs) in female computer users. Rawal Medical Journal. 2019;44(1):151.
15. Agung I, Murdana N, Purba H. The Relationship Between The Body Mass Index and The
Pain Threshold in Myofascial Pain Syndrome: A Cross-sectional Study. Indonesian Journal
of Physical Medicine and Rehabilitation. 2017;6(01):8–17.
16. McVinnie DS. Obesity and pain. Br J Pain. 2013 Jul;
17. Mejuto-Vázquez MJ, Salom-Moreno J, Ortega-Santiago R, Truyols-Domínguez S,
Fernández-De-Las-peñas C. Short-term changes in neck pain, widespread pressure pain
sensitivity, and cervical range of motion after the application of trigger point dry needling in
15
patients with acute mechanical neck pain: a randomized clinical trial. Journal of orthopaedic
& sports physical therapy. 2014;44(4):252–60.
18. Aydın T, Dernek B, Sentürk Ege T, Karan A, Aksoy C. The effectiveness of dry needling
and exercise therapy in patients with dizziness caused by cervical myofascial pain
syndrome; prospective randomized clinical study. Pain Medicine. 2019;20(1):153–60.
19. Taofik N, Prabowo T, Sastradimaja SB. Perbedaan Efek Terapi Penggunaan Dua Ukuran
Jarum Dry Needling dengan Penurunan Nyeri dan Tenderness pada Sindrom Nyeri
Miofasial Otot Upper Trapezius Tipe Aktif. Majalah Kedokteran Bandung. 2015;47(2):91–
5.
20. Retno Setianing. Pengaruh Latihan Tari Poco-Poco terhadap Respons Imun, Insulin-Like
Growth Factor-1 ( LGF-1) dan Kualitas Hidup pada Lansia (Tinjauan
Psikoneuroimunologi). Institutional Repository UNS. 2018;
21. Sheikhhoseini R, Shahrbanian S, Sayyadi P, O’Sullivan K. Effectiveness of therapeutic
exercise on forward head posture: a systematic review and meta-analysis. J Manipulative
Physiol Ther. 2018;41(6):530–9.