Immediate Effects of Instrument-Assisted Soft Tissue Mobilization Combined with Self-Stretching on Pain, Cervical Range of Motion, and Pressure Pain Threshold in Individuals with Upper Trapezius Myofascial Trigger Points: A Single-Group Pilot Study
Abstract
Background: Myofascial trigger points (MTrPs) in the upper trapezius are commonly associated with neck and shoulder pain, restricted cervical mobility, and local mechanical hypersensitivity. Instrument-assisted soft tissue mobilization (IASTM) is used clinically for soft-tissue pain and mobility restriction; however, evidence regarding the immediate response of upper trapezius MTrPs to a single treatment session remains limited.
Objective: To examine immediate changes in pain intensity, active cervical range of motion (CROM), and pressure pain threshold (PPT) after a single session of IASTM combined with upper trapezius self-stretching.
Methods: This single-group pre-post pilot study included 13 participants with clinically active upper trapezius MTrPs. Pain intensity was assessed using a 0-10 visual analogue scale (VAS), CROM using a universal goniometer, and PPT using a handheld mechanical algometer. Participants received standardized IASTM to the upper trapezius followed by self-stretching. Outcomes were recorded immediately before and after the intervention. Following assessment of normality with the Shapiro-Wilk test, paired t tests were used to compare pre- and post-intervention values; statistical significance was set at p < 0.05.
Results: Mean VAS pain decreased from 6.15 ± 0.99 to 2.69 ± 0.95 (mean change, -3.46 points; p < 0.0001). Active CROM increased in all six measured directions, with mean gains ranging from 5.54° to 8.23° (all p ≤ 0.0002). In contrast, PPT decreased bilaterally: right upper trapezius, 41.08 ± 8.72 to 31.77 ± 7.04 N (mean change, -9.31 N); left upper trapezius, 40.46 ± 6.96 to 30.69 ± 6.58 N (mean change, -9.77 N); both p < 0.0001. The lower PPT indicates greater immediate mechanical sensitivity.
Conclusion: A single combined session of IASTM and self-stretching was followed by lower pain ratings and greater cervical mobility, but also by a bilateral reduction in PPT. Because the study was uncontrolled and self-stretching was administered as a co-intervention, these within-participant changes cannot be attributed specifically to IASTM. Larger controlled studies with standardized PPT measurement and follow-up beyond the immediate post-treatment period are warranted.
Keywords:
Cervical range of motion; Instrument-assisted soft tissue mobilization; Myofascial trigger points; Neck pain; Pressure pain threshold; Upper trapeziusDownloads
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Copyright (c) 2026 Yogesh Khairmode, Deepak B. Anap (Author)
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