Dry Needling and Maitland Joint Mobilization Techniques in Patients With Myofacial Chronic Neck Pain

Inclusion Criteria: * Bilateral pain involving the upper trapezius and elevator muscle of the scapula; * Duration of pain of at least 3 months; * A pain intensity corresponding to at least 20 mm on a 100 mm visual analogue scale (VAS) * Neck pain with symptoms provoked by either neck postures or neck movement; * Pain localized at least in the cervical and occipital regions but not in the orofacial region; * Neck disability index (NDI) greater than or equal to 15 points; * Restricted cervical range of movements (flexion, extension, rotation, and sidebending); (i) Presence of bilateral MTrPs in upper trapezius and levator scapulae muscles Exclusion Criteria: * Any signs, symptoms, or history of the following diseases: * Orofacial pain and temporo-mandibular disorders * A history of traumatic injuries (e.g., contusion, fracture, and whiplash injury); * Systemic diseases such as fibromyalgia, systemic erythematous lupus, and arthritis; (d) Neurologic disorders (e.g., trigeminal neuralgia or occipital neuralgia); * Concomitant medical diagnosis of any primary headache (tension type or migraine); * Unilateral neck pain; * Cervical spine surgery; * Clinical diagnosis of cervical radiculopathy or myelopathy; * Needle phobia; * History of previous physical therapy intervention for the cervical region in last 6 months.