Research Article| Volume 78, 105071, August 2020

The effect of vibration therapy on neck myofascial trigger points: A randomized controlled pilot study


      • Mechanical vibration could be used as a self-applied method to reduce neck pain.
      • Self-applied mechanical vibration increases sensitivity at cervical muscles.
      • Self-applied mechanical vibration reduces neck pain and disability.
      • Improvements in sensitivity increase as more vibration sessions are received.
      • Improvements in neck pain and disability increase as more vibration sessions are received.



      The purpose of this study was to evaluate the effect of low-frequency self-administered vibration therapy into myofascial trigger points in the upper trapezius and levator scapulae on patients with chronic non-specific neck pain.


      Twenty-eight patients with chronic non-specific neck pain were randomly assigned into a vibration group, receiving 10 self-applied sessions of vibration therapy in the upper trapezius and levator scapulae trigger points; or a control group, receiving no intervention. Self-reported neck pain and disability (Neck Disability Index) and pressure pain threshold were assessed at baseline and after the first, fifth and 10th treatment sessions.


      Significant differences were found in the vibration group when compared to the control group after the treatment period: the vibration group reached lower Neck Disability Index scores (F = 4.74, P = .033, η2 = 0.07) and greater pressure pain threshold values (F = 7.56, P = .01, η2 = 0.10) than the control group. The vibration group reported a significant reduction in Neck Disability Index scores (χ2 = 19,35, P = .00, Kendall's W = 0.28) and an increase in pressure pain threshold (χ2 = 87,10, P = .00, Kendall's W = 0.73) between the assessment times over the course of the treatment. The mean increase in pressure pain threshold in the vibration group after the 10 sessions was 8.54 N/cm2, while the mean reduction in Neck Disability Index scores was 4.53 points.


      Vibration therapy may be an effective intervention for reducing self-reported neck pain and disability and pressure pain sensitivity in patients with chronic non-specific neck pain. This tool could be recommended for people with non-specific neck pain.



      MTrPs (Myofascial trigger points), VT (Vibration therapy), DOMS (Delayed onset muscle soreness), PPT (Pressure pain threshold), CG (Control group), NDI (Neck Disability Index), VG (Vibration therapy group)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Clinical Biomechanics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Alguacil I.M.
        • Conches M.G.
        • Fraile A.
        • Morales M.
        Vibratory platforms: neurophysiological bases, physiological effects and therapeutic applications.
        Arch. Med. Deporte. 2009; 26: 119-129
        • Andrade Ortega J.A.
        • Delgado Martínez A.D.
        • Almécija Ruíz R.
        Validation of the spanish version of the neck disability index.
        Spine (Phila Pa 1976). 2010; 35: E114-E118
        • Armstrong W.J.
        • Grinnell D.C.
        • Warren G.S.
        The acute effect of whole-body vibration on the vertical jump height.
        J. Strenght Cond. Res. 2010; 24: 2835-2839
        • Artner J.
        • Cakir B.
        • Spiekermann J.A.
        • et al.
        Prevalence of sleep deprivation in patients with chronic neck and back pain: a retrospective evaluation of 1016 patients.
        J. Pain Res. 2013; 6: 1-6
        • Bal M.I.
        • Sattoe J.N.
        • Roelofs P.D.
        • Bal R.
        • van Staa A.
        • Miedema H.S.
        Exploring effectiveness and effective components of self-management interventions for young people with chronic physical conditions: a systematic review.
        Patient Educ. Couns. 2016; 99: 1293-1309
        • Bialosky J.E.
        • Beneciuk J.M.
        • Bishop M.D.
        • et al.
        Unraveling the mechanisms of manual therapy: modeling an approach.
        J. Orthop. Sports Phys. Ther. 2017; 15: 1-31
        • Bishop M.D.
        • Mintken P.E.
        • Bialosky J.E.
        • et al.
        Patient expectations of benefit from interventions for neck pain and resulting influence on outcomes.
        J. Orthop. Sports Phys. Ther. 2013; 43: 457-465
        • Cagnie B.
        • Dewitte V.
        • Barbe T.
        • et al.
        Physiologic effects of dry needling.
        Curr. Pain Headache Rep. 2013; 17348
        • Cagnie B.
        • Castelein B.
        • Pollie F.
        • et al.
        Evidence for the use of ischemic compression and dry needling in the management of trigger points of the upper trapezius in patients with neck pain: a systematic review.
        Am. J. Phys. Med. Rehabil. 2015; 94: 573-583
        • Celik D.
        • Mutlu E.K.
        Clinical implication of latent myofascial trigger point.
        Curr. Pain Headache Rep. 2013; 17353
        • Chan Y.C.
        • Wang T.J.
        • Chang C.C.
        • et al.
        Short-term effects of self-massage combined with home exercise on pain, daily activity, and autonomic function in patients with myofascial pain dysfunction syndrome.
        J. Phys. Ther. Sci. 2015; 27: 217-221
        • Chesterton L.S.
        • Barlas P.
        • Foster N.E.
        • Baxter G.D.
        • Wright C.C.
        Gender differences in pressure pain threshold in healthy humans.
        Pain. 2003; 101: 259-266
        • Cohen J.
        Statistical Power Analysis for the Behavioral Sciences.
        2nd ed. Erlbaum, Hillsdale, NJ1988
        • Cummings M.
        • Baldry P.
        Regional myofascial pain: diagnosis and management.
        Best Pract. Res. Clin. Rheumatol. 2007; 21: 367-387
        • De-la-Llave-Rincón A.I.
        • Alonso-Blanco C.
        • Gil-Crujera A.
        • Ambite-Quesada S.
        • Svensson P.
        • Fernández-de-Las-Peñas C.
        Myofascial trigger points in the masticatory muscles in patients with and without chronic mechanical neck pain.
        J. Manipulative Physiol. Ther. 2012; 35: 678-684
        • Fernández-de-Las-Peñas C.
        • Dommerholt J.
        International consensus on diagnostic criteria and clinical considerations of myofascial trigger points: a Delphi study.
        Pain Med. 2018; 19: 142-150
        • Fernández-de-las-Peñas C.
        • Alonso-Blanco C.
        • Miangolarra J.C.
        Myofascial trigger points in subjects presenting with mechanical neck pain: a blinded, controlled study.
        Man. Ther. 2007; 12: 29-33
        • Fleckenstein J.
        • Zaps D.
        • Rüger L.J.
        • et al.
        Discrepancy between prevalence and perceived effectiveness of treatment methods in myofascial pain syndrome: results of a cross-sectional, nationwide survey.
        BMC Musculoskelet. Disord. 2010; 1132
        • Franklin N.C.
        • Ali M.M.
        • Robinson A.T.
        • Norkeviciute E.
        • Phillips S.A.
        Massage therapy restores peripheral vascular function after exertion.
        Arch. Phys. Med. Rehabil. 2014; 95: 1127-1134
        • Frey Law L.A.
        • Evans S.
        • Knudtson J.
        • Nus S.
        • Scholl K.
        • Sluka K.A.
        Massage reduces pain perception and hyperalgesia in experimental muscle pain: a randomized, controlled trial.
        J. Pain. 2008; 9: 714-721
        • Gam A.N.
        • Warming S.
        • Larsen L.H.
        • et al.
        Treatment of myofascial trigger-points with ultrasound combined with massage and exercise: a randomized controlled trial.
        Pain. 1998; 77: 73-79
        • Giamberardino M.A.
        • Affaitati G.
        • Fabrizio A.
        • Costantini R.
        Myofascial pain syndromes and their evaluation.
        Best Pract. Res. Clin. Rheumatol. 2011; 25: 185-198
        • Gordon S.J.
        • Grimmer-Somers K.A.
        • Trott P.H.
        Pillow use: the behavior of cervical stiffness, headache and scapular/arm pain.
        J. Pain Res. 2010; 3: 137-145
        • Gross A.R.
        • Paquin J.P.
        • Dupont G.
        • et al.
        Exercises for mechanical neck disorders: a Cochrane review update.
        Man. Ther. 2016; 24: 25-45
        • Hong C.Z.
        • Chen Y.C.
        • Pon C.H.
        • Yu J.
        Inmediate effects of various physical medicine modalities on pain threshold of an active myofascial trigger point.
        J. Musculoskel. Pain. 1993; 1: 37-53
        • Hutting N.
        • Johnston V.
        • Staal J.B.
        • Heerkens Y.F.
        Promoting the use of self-management strategies for people with persistent musculoskeletal disorders: the role of physical therapists.
        J. Orthop. Sports Phys. Ther. 2019; 49 (Ap): 212-215
        • Hutting N.
        • Johnston V.
        • Richardson J.
        • Walsh N.
        The role of self-management in the treatment of musculoskeletal disorders [symposium].
        in: World Confederation for Physical Therapy Congress; July 2-4. 2017 (Cape Town, South Africa)
        • Imtiyaz S.
        • Veqar Z.
        • Shareef M.Y.
        To compare the effect of vibration therapy and massage in prevention of delayed onset muscle soreness (DOMS).
        J. Clin. Diagn. Res. 2014; 8: 133-136
        • Issurin V.B.
        Vibrations and their applications in sport: a review.
        J. Sports Med. Phys. Fit. 2005; 45: 324-336
        • Itoh K.
        • Okada K.
        • Kawakita K.
        A proposed experimental model of myofascial trigger points in human muscle after slow eccentric exercise.
        Acupunct. Med. 2004; 22: 2-12
        • Jahr S.
        • Schoppe B.
        • Reisshauer A.
        Effect of treatment with low-intensity and extremely low-frequency electrostatic fields (deep oscillation) on breast tissue and pain in patients with secondary breast lymphedema.
        J. Rehabil. Med. 2008; 40: 645-650
        • Järvinen T.A.
        • Järvinen T.L.
        • Kaariainen M.
        • et al.
        Muscle injuries: optimising recovery.
        Best Pract. Res. Clin. Rheumatol. 2007; 21: 317-331
        • Jonkman N.H.
        • Schuurmans M.J.
        • Jaarsma T.
        • Shortridge-Baggett L.M.
        • Hoes A.W.
        • Trappenburg J.C.
        Self-management interventions: proposal and validation of a new operational definition.
        J. Clin. Epidemiol. 2016; 80: 34-42
        • Khamwong P.
        • Pirunsan U.
        • Paungmali A.
        A prophylactic effect of massage on symptoms of muscle damage induced by eccentric exercise of the wrist extensors.
        J. Bodyw. Mov. Ther. 2011; 15: 507-516
        • Khan K.M.
        • Scott A.
        Mechanotherapy: how physical therapists' prescription of exercise promotes tissue repair.
        Br. J. Sports Med. 2009; 43: 247-252
        • Kietrys D.M.
        • Palombaro K.M.
        • Azzaretto E.
        • et al.
        Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis.
        J. Orthop. Sports Phys. Ther. 2013; 43: 620-634
        • Kim D.H.
        • Yoon D.M.
        • Yoon K.B.
        The effects of myofascial trigger point injections on nocturnal calf cramps.
        J. Am. Board Fam. Med. 2015; 28: 21-27
        • Kraft K.
        • Kanter S.
        • Janik H.
        Safety and effectiveness of vibration massage by deep oscillations: a prospective observational study.
        Evid. Based Complement. Alternat. Med. 2013; 2013: 1-10
        • Kreimer A.J.
        The Low-Frequency Vibrations as a Curative Factor. Tomsk.
        • Lauche R.
        • Cramer H.
        • Hohmann C.
        • et al.
        The effect of traditional cupping on pain and mechanical thresholds in patients with chronic nonspecific neck pain: a randomized controlled pilot study.
        Evid. Based Complement. Alternat. Med. 2012; 2012 (429718)
        • Lindemann K.
        • Teirich-Leube H.
        • Heipertz W.
        Tratado de Rehabilitación. Estudio Preventivo, Médico, Laboral y Social.
        vol. 1. Labor S.A, Barcelona1970
        • Lluch E.
        • Arguisuelas M.D.
        • Coloma P.S.
        • Palma F.
        • Rey A.
        • Falla D.
        Effects of deep cervical flexor training on pressure pain thresholds over myofascial trigger points in patients with chronic neck pain.
        J. Manipulative Physiol. Ther. 2013; 36: 604-611
        • Lobbezoo F.
        • Visscher C.M.
        • Naeije M.
        Impaired health status, sleep disorders, and pain in the craniomandibular and cervical spinal regions.
        Eur. J. Pain. 2004; 8: 23-30
        • Lu X.
        • Wang Y.
        • Lu J.
        • et al.
        Does vibration benefit delayed-onset muscle soreness?: a meta-analysis and systematic review.
        J. Int. Med. Res. 2019; 47: 3-18
        • Lucas K.
        • Polus B.
        • Rich P.
        Latent myofascial trigger points: their effects on muscle activation and movement efficiency.
        J. Bodyw. Mov. Ther. 2004; 8: 160-166
        • Lundeberg T.
        • Nordemar R.
        • Ottoson D.
        Pain alleviation by vibratory stimulation.
        Pain. 1984; 20: 25-44
        • MacDermid J.C.
        • Walton D.M.
        • Avery S.
        • et al.
        Measurement properties of the neck disability index: a systematic review.
        J. Orthop. Sports Phys. Ther. 2009; 39: 400-416
        • Mansilla-Ferragut P.
        • Fernández-de-Las Peñas C.
        • Alburquerque-Sendín F.
        • Cleland J.A.
        • Boscá-Gandía J.J.
        Immediate effects of atlanto-occipital joint manipulation on active mouth opening and pressure pain sensitivity in women with mechanical neck pain.
        J. Manipulative Physiol. Ther. 2009; 32: 101-106
        • Melzack R.
        • Wall P.D.
        Pain mechanisms: a new theory.
        Science. 1965; 150: 971-979
        • Mintken P.E.
        • Rodeghero J.
        • Cleland J.A.
        Manual therapists - have you lost that loving feeling?!.
        J. Man Manip. Ther. 2018; 26: 53-54
        • Muñoz-Muñoz S.
        • Muñoz-García M.T.
        • Alburquerque-Sendín F.
        • Arroyo-Morales M.
        • Fernández-de-las-Peñas C.
        Myofascial trigger points, pain, disability, and sleep quality in individuals with mechanical neck pain.
        J. Manipulative Physiol. Ther. 2012; 35: 608-613
        • Pecos-Martín D.
        • Montañez-Aguilera F.J.
        • Gallego-Izquierdo T.
        • et al.
        Effectiveness of dry needling on the lower trapezius in patients with mechanical neck pain: a randomized controlled trial.
        Arch. Phys. Med. Rehabil. 2015; 96: 775-781
        • Peer K.
        • Barkley J.
        • Knapp D.
        The acute effects of local vibration therapy on ankle sprain and hamstring strain injuries.
        Phys. Sportsmed. 2009; 37: 31-38
        • Sarrafzadeh J.
        • Ahmadi A.
        • Yassin M.
        The effects of pressure release, phonophoresis of hydrocortisone, and ultrasound on upper trapezius latent myofascial trigger point.
        Arch. Phys. Med. Rehabil. 2012; 94: 2146-2150
        • Sherman K.J.
        • Cherkin D.C.
        • Hawkes R.J.
        • Miglioretti D.L.
        • Deyo R.A.
        Randomized trial of therapeutic massage for chronic neck pain.
        Clin. J. Pain. 2009; 25: 233-238
        • Simons D.G.
        Review of enigmatic MTrPs as a common cause of enigmatic musculoskeletal pain and dysfunction.
        J. Electromyogr. Kinesiol. 2004; 14: 95-107
        • Simons D.G.
        • Travell J.
        • Simons L.S.
        Myofascial Pain and Dysfunction. The Trigger Point Manual.
        2nd ed. vol. 1. Williams & Wilkins, Baltimore1999
        • Thompson W.R.
        • Scott A.
        • Loghmani M.T.
        • Ward S.R.
        • Warden S.J.
        Understanding mechanobiology: physical therapists as a force in mechanotherapy and musculoskeletal regenerative rehabilitation.
        Phys. Ther. 2016; 96: 560-569
        • Vanderweeën L.
        • Oostendorp R.A.
        • Vaes P.
        • Duquet W.
        Pressure algometry in manual therapy.
        Man. Ther. 1996; 1: 258-265
        • Veqar Z.
        • Imtiyaz S.
        Vibration therapy in management of delayed onset muscle soreness (DOMS).
        J. Clin. Diagn. Res. 2014; 8: LE01-4
        • Vernon H.
        The neck disability index: state-of-the-art, 1991-2008.
        J. Manipulative Physiol. Ther. 2008; 31: 491-502
        • Vernon H.
        • Mior S.
        The neck disability index: a study of reliability and validity.
        J. Manipulative Physiol. Ther. 1991; 14: 409-415
        • Vernon H.
        • Schneider M.
        Chiropractic management of myofascial trigger points and myofascial pain syndrome: a systematic review of the literature.
        J. Manipulative Physiol. Ther. 2009; 32: 14-24
        • Voogt L.
        • de Vries J.
        • Meeus M.
        • Struyf F.
        • Meuffels D.
        • Nijs J.
        Analgesic effects of manual therapy in patients with musculoskeletal pain: a systematic review.
        Man. Ther. 2015; 20: 250-256
        • Walton D.M.
        • Macdermid J.C.
        • Nielson W.
        • Teasell R.W.
        • Nailer T.
        • Maheu P.
        A descriptive study of pressure pain threshold at 2 standardized sites in people with acute or subacute neck pain.
        J. Orthop. Sports Phys. Ther. 2011; 41: 651-657
        • Walton D.
        • MacDermid J.
        • Nielson W.
        • Teasell R.
        • Chiasson M.
        • Brown L.
        Reliability, standard error, and minimum detectable change of clinical pressure pain threshold testing in people with and without acute neck pain.
        J. Orthop. Sports Phys. Ther. 2011; 41: 644-650
        • Weerapong P.
        • Hume P.A.
        • Kolt G.S.
        The mechanisms of massage and effects on performance, muscle recovery and injury prevention.
        Sports Med. 2005; 35: 235-256
        • Ylinen J.
        • Nykänen M.
        • Kautiainen H.
        • Häkkinen A.
        Evaluation of repeatability of pressure algometry on the neck muscles for clinical use.
        Man. Ther. 2007; 12: 192-197