The goal of this clinical trial is to learn whether pharmacopuncture with Platelet-Rich Plasma (PRP) is effective for treating chronic neck pain in cervical myofascial syndrome related to the upper trapezius muscle. The main questions it aims to answer are: 1. Is pharmacopuncture with Platelet-Rich Plasma (PRP) effective in reducing chronic neck pain in patients with cervical myofascial syndrome related to the upper trapezius muscle? 2. Does PRP pharmacopuncture improve functional outcomes and quality of life in these patients? 3. Are there any adverse effects associated with PRP pharmacopuncture in this context? Researchers will compare PRP pharmacopuncture to normal saline pharmacopuncture (placebo) to evaluate whether PRP provides greater effectiveness in reducing chronic neck pain in cervical myofascial syndrome related to the upper trapezius muscle. Participants will: * Receive a single session of pharmacopuncture therapy * Undergo evaluations at week 2, week 4, and week 8 after the intervention
This is a clinical trial study to evaluate the effectiveness of PRP pharmacopuncture in patients with chronic neck pain in cervical myofascial syndrome related to the upper trapezius muscle. Participants are 60 males/females aged 18-59 years. They will be divided into two groups: (1) PRP pharmacopuncture and (2) Normal saline (placebo) pharmacopuncture. Each participant will receive a single pharmacopuncture treatment. Therapy efficacy will be assessed at week 2, week 4, and week 8 after the intervention.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
72
Participants in the PRP pharmacopuncture arm will receive a single administration of platelet-rich plasma (PRP) via intramuscular injection at acupuncture points corresponding to chronic neck pain in cervical myofascial syndrome in the upper trapezius muscle.
Participants in the placebo pharmacopuncture arm will receive a single administration of normal saline via intramuscular injection at acupuncture points corresponding to chronic neck pain in cervical myofascial syndrome in the upper trapezius muscle.
Fakultas Kedokteran Universitas Indonesia
Jakarta, Indonesia
RECRUITINGBiomarker parameters
The serum concentration of interleukin-1 beta (IL-1β) and vascular endothelial growth factor (VEGF) will be measured as outcome biomarkers to evaluate inflammatory and angiogenic responses following the intervention.
Time frame: before treatment (baseline) and 4 weeks after treatment
Visual Analogue Scale
Pain intensity will be assessed using a 100 mm horizontal visual analogue scale, where 0 mm indicates "no pain" and 100 mm indicates "worst imaginable pain." Participants will mark the point on the line that best represents their perceived pain intensity.
Time frame: before treatment (baseline), 2 weeks, 4 weeks, and 8 weeks after treatment
Pressure Pain Threshold
Using the minimum force applied which induces pain, measured with algometer
Time frame: before treatment (baseline), 2 weeks, 4 weeks, and 8 weeks after treatment
Neck Disability Index
A questionnaire for measuring self-rated disability due to neck pain
Time frame: before treatment (baseline), 2 weeks, 4 weeks, and 8 weeks after treatment
Perceived Stress Scale
psychological instrument for measuring the perception of stress. It assesses the degree to which individuals perceive situations in their lives as stressful over the past month. The scale consists of 10 items, each rated on a 5-point Likert scale ranging from 0 ("never") to 4 ("very often"). Total scores range from 0 to 40, with higher scores indicating greater perceived stress.
Time frame: before treatment (baseline), 2 weeks, 4 weeks, and 8 weeks after treatment
Pain Catastrophizing Scale
a validated self-report questionnaire designed to assess catastrophic thinking related to pain. It consists of 13 items divided into three subscales: rumination, magnification, and helplessness. Each item is rated on a 5-point Likert scale ranging from 0 ("not at all") to 4 ("all the time"), with total scores ranging from 0 to 52. Higher scores reflect greater levels of pain catastrophizing.
Time frame: before treatment (baseline), 2 weeks, 4 weeks, and 8 weeks after treatment
Short-Form 12 Health Survey
designed to assess health-related quality of life (HRQoL) across two main domains: physical and mental health.
Time frame: before treatment (baseline), 2 weeks, 4 weeks, and 8 weeks after treatment
Cervical Range of Motion
To evaluate the degree of movement in cervical flexion, extension, lateral flexion, and rotation using a goniometer or inclinometer.
Time frame: before treatment (baseline), 2 weeks, 4 weeks, and 8 weeks after treatment
Craniovertebral Angle
To assess head and neck posture, measured from lateral photographic analysis.
Time frame: before treatment (baseline), 2 weeks, 4 weeks, and 8 weeks after treatment
Size of Myofascial Trigger Point Nodules
The diameter (in millimeters) of hypoechoic nodules identified at active trigger point sites will be measured using B-mode ultrasound. Measurements will be taken in both longitudinal and transverse planes.
Time frame: before treatment (baseline), 2 weeks, 4 weeks, and 8 weeks after treatment
Resistive Index
The resistive index of the local blood flow surrounding the trigger point area will be assessed using color Doppler and spectral Doppler ultrasound.
Time frame: before treatment (baseline), 2 weeks, 4 weeks, and 8 weeks after treatment
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