Effects of Myofascial Release Versus Dry Cupping on Pain, Muscle Length, and Functional Disability in IT Professionals With Trapezitis.

N/ANot Yet RecruitingNCT07731763

Lahore University of Biological and Applied Sciences52 enrolled

Overview

This study aims to evaluate the effectiveness of two physiotherapy techniques-Myofascial Release and Dry Cupping-in improving pain, muscle length, and functional disability in IT professionals with trapezitis. Trapezitis is a common musculoskeletal condition caused by prolonged static postures and repetitive strain, leading to neck and shoulder pain, reduced muscle flexibility, and functional limitations that affect daily activities and work performance. Although both myofascial release and dry cupping are commonly used in clinical practice, limited evidence exists comparing their effectiveness in this population. Participants diagnosed with trapezitis will be randomized into two groups: Group 1 will receive myofascial release along with routine physical therapy, and Group 2 will receive dry cupping therapy along with routine physical therapy. The interventions will be administered multiple times per week over a specified duration, and participants will be assessed before and after treatment. Outcome measures will include pain intensity using the Numeric Pain Rating Scale (NPRS), muscle length of the upper trapezius, and functional disability using the Neck Disability Index (NDI). The study will compare the effects of both interventions, focusing on pain reduction, improvement in muscle flexibility, and enhancement of functional ability. The findings may help in identifying the more effective treatment approach and contribute to improved management strategies for trapezitis among IT professionals.

Trapezitis is a prevalent musculoskeletal disorder, particularly among IT professionals who are exposed to prolonged computer use, poor ergonomics, and sustained static postures. It primarily affects the upper trapezius muscle and is characterized by pain, muscle tightness, reduced flexibility, and functional disability. These symptoms can interfere with occupational performance, decrease productivity, and negatively impact quality of life. Conservative physiotherapy interventions play a key role in the management of trapezitis. Among these, Myofascial Release (MFR) and Dry Cupping therapy are widely used techniques. Myofascial Release is a manual therapy approach that targets fascial restrictions to improve tissue mobility, reduce pain, and restore muscle length. Dry Cupping, on the other hand, involves the application of suction cups to the skin to enhance blood circulation, relieve muscle tension, and promote healing. Despite their clinical use, there is limited comparative evidence regarding their effectiveness in managing trapezitis. This study aims to compare the effects of Myofascial Release and Dry Cupping on pain intensity, muscle length, and functional disability in IT professionals with trapezitis. Intervention Strategies: Myofascial Release: This technique involves the application of sustained manual pressure to the upper trapezius muscle and surrounding fascia to release restrictions, improve circulation, and enhance tissue extensibility. It aims to reduce pain and restore normal muscle function. Dry Cupping Therapy: This technique involves placing suction cups on the skin over the upper trapezius region to create negative pressure. This promotes increased blood flow, reduces muscle stiffness, and facilitates pain relief. Study Design and Groups: This randomized controlled trial will include IT professionals diagnosed with trapezitis who meet the inclusion criteria. Participants will be randomly assigned into two groups: Group 1 (Experimental Group): Myofascial Release combined with routine physical therapy. Group 2 (Control Group): Dry Cupping Therapy combined with routine physical therapy. The interventions will be conducted several times per week over a defined treatment period (e.g., 4-6 weeks). Each session will be supervised by trained physiotherapists. Outcome Measures: The primary outcomes of the study will include: Pain intensity measured using the Numeric Pain Rating Scale (NPRS), Muscle length of the upper trapezius assessed through standardized measurement techniques, and Functional disability measured using the Neck Disability Index (NDI). Assessments will be conducted at baseline and post-intervention (and mid-intervention if applicable). Data Collection and Analysis: Data will be collected at different time points to evaluate changes in pain, muscle length, and functional disability. Statistical analysis will be performed using appropriate methods such as paired t-tests, independent t-tests, or ANOVA to compare within-group and between-group differences. Safety and Ethics: This study will be conducted following approval from the institutional ethical review board. Informed consent will be obtained from all participants prior to enrollment. All procedures will be carried out by qualified physiotherapists to ensure safety. Potential risks are minimal and may include temporary discomfort, mild soreness, or skin irritation in the case of cupping therapy. Participants will be monitored throughout the intervention period, and any adverse effects will be addressed promptly. Confidentiality of participant data will be strictly maintained, and participation will be voluntary. Significance and Potential Impact: This study has the potential to provide valuable evidence regarding the comparative effectiveness of Myofascial Release and Dry Cupping in managing trapezitis among IT professionals. The findings may assist clinicians in selecting the most appropriate intervention for reducing pain, improving muscle flexibility, and enhancing functional outcomes. Additionally, it may contribute to the development of evidence-based rehabilitation protocols for work-related musculoskeletal disorders. Conclusion: By comparing Myofascial Release with Dry Cupping therapy, this study aims to identify the more effective treatment approach for improving pain, muscle length, and functional disability in IT professionals with trapezitis. The results may support better clinical decision-making and improve rehabilitation outcomes in this population.

Interventions

Myofascial ReleaseOTHER

Myofascial Release (MFR) is a manual therapy targeting fascial restrictions and trigger points in the upper trapezius. In this study, it involves slow, sustained pressure, stretching, and gliding techniques to restore tissue mobility and reduce muscle tension. Unlike dry cupping, which uses negative pressure and acts more superficially, MFR directly engages deeper fascial layers through therapist-guided contact, allowing precise identification and treatment of restrictions. For IT professionals with trapezitis, prolonged postures lead to tightness, reduced muscle length, and disability. MFR applies pressure for 90-120 seconds to achieve fascial relaxation, improve circulation, and enhance muscle extensibility. This results in reduced pain and improved function. Its individualized, feedback-based approach distinguishes it from the more passive application of dry cupping, making it effective for addressing underlying dysfunction.

Dry CuppingOTHER

Dry cupping therapy is a non-invasive technique that uses negative pressure to lift the skin and superficial tissues over the upper trapezius. In this study, cups are applied to tender, hypertonic areas to improve blood flow, reduce stiffness, and relieve pain. Unlike Myofascial Release, which uses direct manual pressure and deep fascial manipulation, dry cupping works indirectly through suction without continuous therapist contact. In IT professionals with trapezitis, prolonged postures lead to tightness and discomfort. Dry cupping enhances microcirculation, reduces nociceptive input, and supports tissue relaxation, resulting in pain relief and functional improvement. Suction intensity is adjusted based on tolerance and skin response. Its passive, suction-based mechanism distinguishes it from the active, hands-on approach of Myofascial Release.

Eligibility

Sex: ALLMin age: 25 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: IT professionals aged 20-65 years diagnosed with trapezitis (upper trapezius myofascial pain) characterized by pain and tenderness in the upper trapezius region for at least 4 weeks. Participants must have a pain intensity of ≥3 on the Numeric Pain Rating Scale (NPRS), exhibit restricted cervical range of motion or reduced upper trapezius muscle length as assessed using a goniometer. Functional disability must be present as indicated by a Neck Disability Index (NDI) score within the mild to moderate range (e.g., 10-28%), and be engaged in computer-based work for a minimum of 6 hours per day. Both male and female participants who provide informed consent will be included. Exclusion Criteria: Individuals with a history of cervical spine pathology including disc herniation, radiculopathy, or spondylosis with neurological involvement; previous trauma or surgery involving the cervical spine, shoulder girdle, or upper thoracic region; presence of symptomatic or inflammatory musculoskeletal conditions (e.g., rheumatoid arthritis, ankylosing spondylitis, fibromyalgia); neurological disorders affecting the upper limb or cervical region (e.g., peripheral neuropathy, myelopathy); skin conditions or contraindications to cupping therapy (e.g., open wounds, active infections, eczema, psoriasis); bleeding disorders or current anticoagulant therapy; pregnancy; and inability to comply with the treatment protocol or follow-up assessments will be excluded.

Outcomes

Primary Outcomes

Numeric Pain Rating scale

Pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS), a unidimensional self-reported measure widely used in musculoskeletal and neck pain research. The NPRS consists of an 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain). Participants will be asked to rate their current level of neck or upper trapezius pain at rest. The NPRS has demonstrated excellent test-retest reliability (ICC = 0.95-0.96), strong construct validity, and high responsiveness for detecting clinically meaningful changes in individuals with neck pain. A change of 2 points or 30% reduction is considered the minimal clinically important difference (MCID) in musculoskeletal conditions. Due to its simplicity, sensitivity, and minimal respondent burden, the NPRS is recommended for use in clinical trials involving neck and trapezius pain.

Time frame: 4 weeks

Secondary Outcomes

Muscle Length

Upper trapezius muscle length will be assessed using a standardized tape-measure method during controlled cervical side-flexion with contralateral rotation. Measurements will be taken by recording the linear distance between fixed anatomical landmarks, from the mastoid process to the acromion, while maintaining consistent posture and head positioning. Participants will be seated upright with thoracic support, and compensatory trunk movements will be avoided. Assessments will be conducted at baseline, mid-intervention (end of week 2), and post-intervention (after 4 weeks) to evaluate short-term and progressive changes in muscle extensibility. This method is reliable, practical, and cost-effective for assessing superficial muscle length, particularly in the upper trapezius. With standardized positioning and consistent landmark identification, it shows good intra-rater reliability and sensitivity to change following interventions, enabling objective comparison between treatment groups.