EFFECTS OF INTEGRATED NEUROMUSCULAR INHIBITION TECHNIQUEONUPPER TRAPEZIUS TRIGGER POINTS IN PATIENTS WITHNONSPECIFICNECK PAIN: RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Non-specific neck pain is a prevalent musculoskeletal disorder significantly affecting daily function and quality of life. Myofascial trigger points in the upper trapezius are a common source of persistent pain, often requiring targeted interventions for effective management. Conventional physical therapy modalities, including heating, posture correction, and electrical stimulation, are frequently used; however, their efficacy in complete symptom resolution remains variable. Integrated neuromuscular inhibition technique (INIT) has emerged as a promising approach for trigger point deactivation, yet its comparative effectiveness remains underexplored.

Objective: To evaluate the effect of INIT on upper trapezius trigger points in patients with non-specific neck pain compared to conventional physical therapy alone.

Methods: A single-blinded randomized controlled trial was conducted over nine months at the Physical Therapy Department, JIMS Hospital, Jacobabad. A total of 58 participants were randomly allocated into two groups. Group A (n=29) received conventional physical therapy, including 30-minute sessions of heating, posture corrective exercises, transcutaneous electrical nerve stimulation (TENS), traction, short-term immobilization, acupuncture, chiropractic treatment, and massage, five times per week for eight weeks. Group B (n=29) received the same protocol with an additional 20–30 minutes of INIT per session. Outcome measures included the Neck Disability Index (NDI) and Numeric Pain Rating Scale (NPRS), assessed pre- and post-treatment. Non-parametric statistical tests were applied, with a significance threshold of p<0.05.

Results: At baseline, the mean NPRS score was 7.19 ± 0.66 in Group A and 6.75 ± 0.73 in Group B. Post-treatment, NPRS scores significantly improved to 0.80 ± 0.40 in Group A and 0.91 ± 0.28 in Group B (p<0.05). NDI scores also improved from 28.64 ± 3.20 to 12.00 ± 2.40 in Group A and from 30.36 ± 3.70 to 10.00 ± 2.10 in Group B (p<0.05). Inter-group comparison showed significantly greater improvements in Group B (p<0.05).

Conclusion: INIT, when combined with conventional physical therapy, is more effective than conventional treatment alone in reducing pain and disability associated with non-specific neck pain. The addition of INIT demonstrated superior outcomes in pain reduction and functional recovery, suggesting its potential integration into routine rehabilitation protocols.