Comparative Effect of Instrument-Assisted Soft Tissue Mobilization and Deep Transverse Friction Massage in Patients With Trapezius Myalgia

Overview

This randomized controlled trial compares the effectiveness of Instrument-Assisted Soft Tissue Mobilization (IASTM) and Deep Transverse Friction Massage (DTFM) in patients with trapezius myalgia. A total of 42 participants aged 18-45 years will be randomly assigned to either intervention group. Both groups will also receive conventional physiotherapy consisting of TENS, hot packs, range-of-motion exercises, and stretching. Treatment will be provided four sessions per week for four weeks. Outcomes include pain intensity, cervical range of motion, muscle strength, and functional disability.

Trapezius myalgia is a common musculoskeletal disorder characterized by pain, muscle tightness, stiffness, fatigue, and reduced cervical movement. It commonly develops due to poor posture, prolonged desk work, repetitive upper-limb activities, and occupational stress. These symptoms reduce functional ability and quality of life. Although both Instrument-Assisted Soft Tissue Mobilization (IASTM) and Deep Transverse Friction Massage (DTFM) are widely used in physiotherapy, evidence comparing their effectiveness is limited. Therefore, this study aims to determine which intervention provides greater improvements in pain, cervical range of motion, muscle strength, and functional disability. The study will be conducted as a randomized controlled trial at the Department of Physical Therapy, Ibadat International University Islamabad. Forty-two participants will be recruited using a sample size calculated through OpenEpi. Eligible participants will be randomly allocated into two intervention groups. Both groups will receive conventional physiotherapy consisting of Transcutaneous Electrical Nerve Stimulation (TENS), hot pack application, active range-of-motion exercises, and stretching exercises. Treatment will be administered four sessions per week for four weeks (16 sessions). The DTFM group will receive manual deep transverse friction massage over the upper trapezius muscle to reduce pain, release adhesions, and improve tissue mobility. The IASTM group will receive soft tissue mobilization using stainless-steel instruments to improve circulation, release fascial restrictions, and promote tissue healing. Outcome measures will include the Numeric Pain Rating Scale (NPRS), Bubble Inclinometer for cervical range of motion, Hand-Held Dynamometer for muscle strength, and Neck Disability Index (NDI). Data will be analyzed using SPSS version 25 with appropriate parametric or non-parametric statistical tests. Statistical significance will be set at p ≤ 0.05. The findings will contribute to evidence-based physiotherapy practice by identifying the more effective manual therapy technique for treating trapezius myalgia.