An interventional study of Dry Needle and Low-Level Laser Microcurrent Electrical Stimulation in Myofacial Pain Syndrome, sponsored by Udayana University. Recruiting at 1 site in Indonesia. Open to participants aged 20 Years to 45 Years. Per ClinicalTrials.gov, last updated 2026-08-10.
Sponsored by Udayana University · Not applicable, Interventional, and Basic science
This study aims to evaluate the effectiveness of dry needling and Low-Level Laser Microcurrent Electrical Stimulation (LL MCES) in patients with acute upper trapezius myofascial pain syndrome (MPS) by assessing both biological and clinical outcomes. Specifically, it investigates whether these interventions reduce serum levels of the inflammatory biomarker tumor necrosis factor-alpha (TNF-α) and the oxidative stress biomarker malondialdehyde (MDA), while also improving pain intensity and neck-related disability. The study seeks to address the current knowledge gap regarding the relationship between changes in inflammatory and oxidative stress biomarkers and clinical improvement following these non-pharmacological treatments. The primary research question is: Do dry needling and LL MCES reduce serum TNF-α and MDA levels and improve clinical outcomes in patients with acute upper trapezius myofascial pain syndrome?
Participants will:
Be randomly assigned to receive dry needling, LL MCES, combined dry needling and LL MCES, or sham dry needling.
Receive treatment according to the assigned intervention protocol. Undergo blood sampling before and after the intervention to measure serum TNF-α and MDA levels.
Complete assessments of pain intensity using the Numerical Pain Rating Scale (NPRS) and neck-related disability using the Neck Disability Index (NDI) before and after treatment.
Attend scheduled follow-up visits for clinical evaluation and outcome assessment.
Myofascial pain syndrome (MPS) is a common musculoskeletal pain disorder characterized by the presence of myofascial trigger points within skeletal muscle, resulting in localized and referred pain, reduced range of motion, and functional impairment. Acute upper trapezius MPS is associated with activation of inflammatory pathways and oxidative stress, including increased production of pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α) and lipid peroxidation products such as malondialdehyde (MDA). These biological processes contribute to peripheral sensitization and may play an important role in the development and persistence of pain.
Dry needling is a minimally invasive intervention that targets myofascial trigger points through insertion of a solid filiform needle to elicit mechanical and neurophysiological responses. Proposed mechanisms include normalization of dysfunctional motor end plates, improvement of local blood flow, reduction of inflammatory mediators, and modulation of peripheral nociceptive input. Low-Level Laser Microcurrent Electrical Stimulation (LL MCES) is a non-pharmacological modality that combines low-level laser therapy with microcurrent electrical stimulation to promote cellular repair, enhance adenosine triphosphate (ATP) production, improve tissue regeneration, and reduce inflammatory activity. Although both interventions have demonstrated clinical benefits in patients with MPS, evidence comparing their effects on systemic inflammatory and oxidative stress biomarkers remains limited.
This study is designed to investigate the biological mechanisms underlying the therapeutic effects of dry needling and LL MCES by evaluating changes in serum TNF-α and MDA concentrations following treatment. Clinical outcomes will be examined concurrently to explore whether biomarker modulation is associated with improvements in pain and functional disability. By integrating objective laboratory measures with patient-reported clinical outcomes, the study aims to provide insight into the pathophysiological mechanisms of treatment response in acute upper trapezius MPS.
The study will employ a prospective randomized controlled design involving adults with acute upper trapezius MPS. Participants will be allocated to one of four intervention groups: dry needling alone, LL MCES alone, combined dry needling and LL MCES, or sham dry needling. Serum TNF-α and MDA levels will be measured before and after the intervention, together with standardized assessments of pain intensity and neck-related disability. The findings are expected to clarify whether biomarker changes parallel clinical improvement and to provide evidence supporting mechanism-based, non-pharmacological management strategies for acute myofascial pain syndrome.
28 studies on the registry are indexed under Facial Neuralgia; 8 are open to participants now.
This study's planned enrollment of 80 is above the median of 55 across 22 interventional studies indexed under Facial Neuralgia.
Browse Facial Neuralgia studies →Udayana University is the lead sponsor of 34 studies on the registry; 8 are open to participants now.
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Adults aged 20 to 45 years. Clinical diagnosis of acute upper trapezius myofascial pain syndrome (MPS) with symptom duration of less than 1 month.
Presence of at least one active myofascial trigger point in the upper trapezius muscle confirmed by physical examination according to accepted diagnostic criteria (palpable taut band, hypersensitive trigger point, reproduction of the patient's typical pain, and/or local twitch response).
Moderate or greater neck pain (Numerical Pain Rating Scale [NPRS] ≥4). Willing and able to provide written and comply with study procedures.
Exclusion Criteria:
Previous dry needling or LL MCES treatment for the current episode of myofascial pain.
Chronic myofascial pain syndrome (symptom duration ≥1 month). Current use of systemic , nonsteroidal anti-inflammatory drugs (NSAIDs), or other medications that may significantly influence inflammatory biomarkers within the specified in the protocol.
Previous surgery, fracture, or significant trauma involving the neck or shoulder region.
Cervical radiculopathy, cervical myelopathy, fibromyalgia, inflammatory arthritis, or other neurological or musculoskeletal disorders that could explain the symptoms.
Local skin infection, open wound, or other to dry needling or LL MCES.
Bleeding disorders, anticoagulant therapy, or other contraindications to needling.
Pregnancy or breastfeeding. Active , disease, uncontrolled diabetes mellitus, acute infection, or other systemic inflammatory conditions.
History of severe psychiatric illness or inability to complete study assessments.
Participation in another interventional clinical trial within the previous 30 days.
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.
Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.
A planned gap after a treatment, so that its effects can lessen before the study treatment or a study assessment. Ask the study team and the doctor who prescribed it before changing any medicine.
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.
Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.
A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.
Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Corticosteroids (steroids)
Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.
Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Washout period
A planned gap after a treatment, so that its effects can lessen before the study treatment or a study assessment. Ask the study team and the doctor who prescribed it before changing any medicine.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Contraindication
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Cancer (malignancy)
Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.
Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Autoimmune disease
A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.
Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Participants receive dry needling treatment targeting active myofascial trigger points in the upper trapezius muscle according to the study protocol.
Device: Dry Needle
Participants receive LL MCES therapy applied to the upper trapezius trigger point region according to the study protocol.
Device: Low-Level Laser Microcurrent Electrical Stimulation
Participants receive both dry needling and LL MCES during the same treatment session according to the study protocol.
Device: Dry Needle · Device: Low-Level Laser Microcurrent Electrical Stimulation
Participants receive a sham dry needling procedure designed to mimic the treatment experience without therapeutic needle penetration of the trigger point.
Device: Sham Dry Needle
Dry needling is performed using a sterile disposable filiform needle inserted into identified active trigger points of the upper trapezius muscle. The needle is manipulated to elicit a local twitch response when possible, and the procedure is conducted by a trained physician following a standardized treatment protocol.
Low-Level Laser Microcurrent Electrical Stimulation (LL MCES) LL MCES is delivered using a therapeutic device that combines low-level laser irradiation and microcurrent electrical stimulation. Treatment parameters, application sites, and duration are standardized across participants.
A validated sham needling technique is used in which the procedure simulates dry needling while avoiding therapeutic penetration of the myofascial trigger point. The duration and treatment setting are matched to the active dry needling intervention.
Change in Serum Malondialdehyde (MDA) Concentration
Change in serum malondialdehyde (MDA) concentration from baseline to post-intervention measured using ELISA. Results will be expressed in nmol/mL. A greater reduction indicates improvement in oxidative stress.
Time frame: Baseline and 3 days after completion of the intervention.
Change in Serum Tumor Necrosis Factor-Alpha (TNF-α) Concentration
Change in serum TNF-α concentration from baseline to post-intervention measured using enzyme-linked immunosorbent assay (ELISA). Results will be expressed in pg/mL. A greater reduction indicates improvement in systemic inflammatory activity.
Time frame: Baseline and 3 days after completion of the intervention.
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