Effects of high-power static ultrasound combined with dry cupping therapy on pain and functional outcomes in patients with trapezius myofascial trigger points: A comparative study

Background

Myofascial pain syndrome (MPS) is a widespread musculoskeletal disorder often associated with trapezius myofascial trigger points (MTrPs), resulting to chronic neck pain, disability, and reduced quality of life. While high-power static ultrasound (HPSU) and dry cupping therapy (DC) have shown efficacy as standalone treatments, their combined effects remain unexplored.

Objective

This study aims to evaluate the combined effect of HPSU and DC compared to DC alone and standard medical care (SMC) in improving pain, range of motion (ROM), functional capacity, and disability in patients with chronic neck pain due to trapezius MTrPs.

Methods

This single-blind randomized clinical trial included 45 patients aged 25–50 years with persistent neck pain (≥3 months) and 5–10 active trapezius MTrPs. Participants were randomized into three groups: (A) HPSU + DC + SMC, (B) DC + SMC, and (C) SMC alone. Interventions consisted of eight sessions over four weeks. Pain (VAS), ROM, functional capacity (Functional Capacity Evaluation), and disability (Neck Disability Index) were assessed at baseline, after the fourth session, and post-intervention. Statistical analysis included repeated measures ANOVA with post-hoc tests and effect size interpretation.

Results

All groups showed significant improvements in pain, ROM, and disability over time (p < 0.05). DC-based interventions (groups A and B) demonstrated better outcomes compared to SMC alone, particularly in ROM (e.g., η² = 0.63 for cervical extension). However, no significant differences has been detected between HPSU + DC and DC-alone groups, indicating that HPSU did not provide additional benefits when combined with DC. Functional capacity improvements were significant in DC-based groups but limited in the SMC group.

Conclusion

Dry cupping therapy alone improves pain, ROM, functional capacity, and disability in patients with trapezius MTrPs. The addition of HPSU does not enhance therapeutic outcomes, underscoring the sufficiency of DC as a standalone treatment. These findings offer practical guidance for clinicians by emphasizing resource-efficient and accessible interventions for managing chronic neck pain. Future research should optimize cupping parameters and explore the effects of combined modalities in diverse populations.