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Myofascial Pain Syndrome (Upper Trapezius)EmmettNCT07767747

Emmett Technique Versus Bowen Technique for Upper Trapezius Myofascial Pain Syndrome

A study testing Group A = Emmett Technique with conventional physiotherapy and Group B = Bowen Technique with conventional physiotherapy in people with Myofascial Pain Syndrome (Upper Trapezius), run by University of Management and Technology Sialkot Pakistan at 1 site in Pakistan.

Enrolling by invitation

Enrolling by invitation. The study team selects and invites participants, usually from an existing group of patients.

Sites and contacts
Official record
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Trial summary

This randomized clinical trial compares the Emmett Technique and Bowen Therapy for patients with upper trapezius myofascial pain syndrome, focusing on their effects on pain, cervical range of motion, and functional disability. Read more about this study

Who is it for?
Ages 18 to 45 years
What is being tested?
Group A = Emmett Technique with conventional physiotherapy and Group B = Bowen Technique with conventional physiotherapy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
46 participants
Where
1 sitePakistan
Study dates
1 Aug 2026to 30 Aug 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 45 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Participants including both male and female
  • Age: 18-45 years
  • Clinical diagnosis of upper trapezius myofascial pain syndrome according to -----Travell and Simons' criteria, including:
  • Taut band Hypersensitive trigger point Referral pain pattern Restricted range of motion
  • Reproduction of pain upon probing
  • Pain duration surpassing 3 months
  • NPRS score: 3-10

Who cannot join

  • Cervical trauma or surgical history
  • Cervical radiculopathy and/or other neurological conditions
  • Psychiatric disorders, malignancies, rheumatologic conditions, or systemic illnesses
  • Fibromyalgia
  • Recent dry needling, trigger-point injection treatments, or other invasive procedures
  • Pregnancy

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Pakistan1 site
  • University of Management and technology Sialkot Campus

    Sialkot, Punjab Province, 51070

Other trials in Pakistan

About this study

Official title: Comparative Effects of the Emmett Technique and the Bowen Technique on Pain, Range of Motion, and Functional Disability in Patients With Upper Trapezius Myofascial Pain Syndrome: A Randomized Clinical Trial

This randomized clinical trial compares the Emmett Technique and Bowen Therapy for patients with upper trapezius myofascial pain syndrome, focusing on their effects on pain, cervical range of motion, and functional disability. The study includes 46 participants, randomly allocated into two groups of 23: Group A receives the Emmett Technique with conventional physiotherapy, while Group B receives Bowen Therapy with conventional physiotherapy. Outcomes are assessed using the Numerical Pain Rating Scale (NPRS), Neck Disability Index (NDI), and Universal Goniometer before and after treatment. The study aims to determine which manual therapy provides greater improvement in pain reduction, cervical mobility, and functional ability.

Read the detailed description

This research is a randomized clinical trial designed to compare the effects of the Emmett Technique and Bowen Therapy on pain intensity, cervical range of motion, and functional disability in patients with upper trapezius myofascial pain syndrome (MPS). Upper trapezius MPS is characterized by the presence of myofascial trigger points within taut skeletal muscle bands and may present with localized or referred pain, muscle stiffness, restricted cervical movement, weakness, and reduced functional performance.

The rationale for conducting this study is that although both the Emmett Technique and Bowen Therapy are increasingly used as manual therapy approaches, there is limited evidence directly comparing their effectiveness. Existing research has largely investigated these techniques independently, creating a gap regarding which intervention may provide superior improvement in pain, range of motion, and functional ability in patients with upper trapezius MPS. The primary objective is therefore to evaluate their relative efficacy in this patient population.

The study includes a total sample of 46 participants, with the sample size calculated using G*Power with an additional 5% attrition rate. A non-probability purposive convenient sampling strategy is used for recruitment. Eligible participants include both males and females aged 18-45 years with a clinical diagnosis of upper trapezius MPS according to Travell and Simons' criteria, including features such as a taut band, hypersensitive trigger point, referred pain pattern, restricted range of motion, and reproduction of pain on probing. Participants are also required to have pain lasting more than three months, an NPRS score of 3-10, and an NDI score between 20 and 35.

Following recruitment, participants are randomized into two groups. Group A consists of 23 participants receiving the Emmett Technique, while Group B consists of 23 participants receiving Bowen Therapy. Both groups additionally receive the same standardized physiotherapy protocol.

In the Emmett Technique group, mild pressure is applied to specific EMMETT points for approximately 5-20 seconds and repeated three times at each point. The first application is used to evaluate the tissue, the second is intended to produce the therapeutic response, and the third reassesses the tissue response. In the Bowen Therapy group, gentle cross-fibre rolling movements are performed over the fascia, tendons, muscles, and ligaments of the upper trapezius and cervical region using light pressure, with approximately two-minute pauses between sets of Bowen movements. Each intervention session lasts approximately 20 minutes, and both groups receive 12 treatment sessions over four weeks, at three sessions per week.

Both groups also receive a standardized physiotherapy protocol, consisting of TENS, hot pack application, strengthening and stretching exercises, and ischemic compression release. The exercise component includes isometric strengthening and stretching of the upper trapezius, supraspinatus, and pectoral muscles.

The primary clinical outcomes are assessed before and after treatment using three measurement tools. The Numerical Pain Rating Scale (NPRS) assesses pain intensity on a 0-10 scale; the Neck Disability Index (NDI) evaluates the impact of neck symptoms on functional activities; and a Universal Goniometer measures cervical range of motion, including flexion, extension, right and left lateral flexion, and right and left rotation.

For statistical analysis, the study uses IBM SPSS version 26.0. The Shapiro-Wilk test is used to assess normality. According to the methodology, the data are considered normally distributed; therefore, paired-sample t-tests are planned for within-group pre- versus post-treatment comparisons, while independent-samples t-tests are used to compare outcomes between the two intervention groups.

Overall, the study is intended to determine whether the Emmett Technique or Bowen Therapy provides greater clinical benefits when combined with standardized physiotherapy for upper trapezius myofascial pain syndrome. By comparing changes in pain, cervical mobility, and neck-related functional disability, the research aims to provide evidence that may assist physiotherapists in selecting a more effective manual therapy approach for this patient population.

Being tested
Group A = Emmett Technique with conventional physiotherapy, Group B = Bowen Technique with conventional physiotherapy
Keywords
Myofascial Pain Syndrome, Upper Trapezius Myofascial Pain Syndrome, Upper Trapezius
Medical subject headings
Myofascial Pain Syndromes

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Group A = Emmett Technique with conventional physiotherapyOther

    The Emmett Technique is a gentle manual therapy approach developed by Ross Emmett. It involves applying light, precise pressure to specific points on the body, known as EMMETT points, where sensory and muscular receptors are thought to interact. In this study, mild pressure is applied to the selected points for approximately 5-20 seconds and repeated three times at the same point. The first application is used to assess the tissue response, the second aims to produce the therapeutic effect, and the third reassesses whether the desired change has occurred. The technique is intended to help reduce pain, improve movement, promote myofascial release, enhance muscle function, and improve overall mobility.

  • Group B = Bowen Technique with conventional physiotherapyOther

    The Bowen Technique (Bowen Therapy) is a gentle, non-invasive manual therapy approach developed by Thomas Bowen. It involves performing light cross-fibre rolling movements over muscles, fascia, tendons, and ligaments, with minimal pressure applied to the tissues. In this study, the technique is applied over the upper trapezius and adjacent cervical region, with approximately 2-minute pauses between sets of Bowen moves to allow the body to respond to the stimulation

Study groups in NCT07767747
Study groupRoleWhat they receive
GROUP A (Emmett Technique)ExperimentalParticipants in Group A will receive the Emmett Technique combined with standardized conventional physiotherapy for upper trapezius myofascial pain syndrome. The Emmett Technique will be applied in a prone position using gentle pressure over specific Emmett points around the upper trapezius and adjacent cervical/shoulder region for approximately 5-20 seconds, repeated three times at each point. Treatment will be provided 3 sessions per week for 4 weeks, for a total of 12 sessions. Conventional physiotherapy will include TENS, hot pack, stretching and strengthening exercises, and ischemic compression release. Outcomes will be assessed before and after treatment using NPRS, NDI, and cervical range of motion measured with a universal goniometer.
Receives: Other: Group A = Emmett Technique with conventional physiotherapy
GROUP A (Bowen Technique)Active comparatorParticipants in Group B will receive the Bowen Technique combined with the same standardized conventional physiotherapy provided to Group A. The Bowen Technique will involve gentle, precise rolling and cross-fiber movements over the upper trapezius and surrounding cervical-shoulder soft tissues, with short rest intervals between sets of movements to allow tissue relaxation and neuromuscular response. Treatment will be administered 3 sessions per week for 4 weeks, for a total of 12 sessions. Conventional physiotherapy will remain identical in both groups so that the comparative effect of the Bowen Technique versus Emmett Technique can be evaluated on pain, disability, and cervical range of motion.
Receives: Other: Group B = Bowen Technique with conventional physiotherapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Numerical Pain Rating Scale

    The NPRS is used to measure the severity of pain experienced by the patient. It is an 11-point scale ranging from 0 to 10, where 0 represents no pain and 10 represents the worst possible pain. In this study, it is used before and after treatment to determine the change in pain intensity following the Emmett Technique or Bowen Therapy.

    Measured: 6 weeks

Secondary outcomes (2)
  1. Functional Disability - Neck Disability Index (NDI)

    The NDI is a self-reported questionnaire used to assess the level of disability associated with neck pain. It contains 10 sections, including pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleeping, and recreation. Each section is scored from 0 to 5, giving a maximum total score of 50, with higher scores indicating greater functional disability

    Measured: 6 weeks

  2. Cervical Range of Motion - Universal Goniometer

    The Universal Goniometer is a simple clinical instrument used to measure joint range of motion in degrees. In this study, it is used to assess cervical flexion, extension, right and left lateral flexion, and right and left rotation before and after the intervention. It consists of a stationary arm, movable arm, and degree scale, allowing objective measurement of changes in cervical mobility.

    Measured: 6 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Aug 2026
  2. Study start1 Aug 2026 (estimated)
  3. Primary completion30 Aug 2026 (estimated)
  4. Study completion30 Aug 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
46 participants → Randomization → Group A: Emmett Technique + Standard Physiotherapy (n=23) \| Group B: Bowen Therapy + Standard Physiotherapy (n=23) → 4 weeks of treatment → Post-treatment assessment → Comparison of pain, ROM, and functional disability.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
46 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07767747
Sponsor's protocol ID
kuhs/dpt/umt-skt-00263
Acronym
Emmett
Status last verified
Aug 2026
First submitted
11 Aug 2026
Last updated
21 Aug 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Agarwal S, Bedekar N, Shyam A, Sancheti P. Comparison between effects of instrument-assisted soft tissue mobilization and manual myofascial release on pain, range of motion and function in myofascial pain syndrome of upper trapezius - A randomized controlled trial. Hong Kong Physiother J. 2024 Jun;44(1):57-67. doi: 10.1142/S1013702524500069. Epub 2023 Oct 26.

    PubMed 38577397
  • Barbero M, Schneebeli A, Koetsier E, Maino P. Myofascial pain syndrome and trigger points: evaluation and treatment in patients with musculoskeletal pain. Curr Opin Support Palliat Care. 2019 Sep;13(3):270-276. doi: 10.1097/SPC.0000000000000445.

    PubMed 31313700
  • Montenegro ML, Gomide LB, Mateus-Vasconcelos EL, Rosa-e-Silva JC, Candido-dos-Reis FJ, Nogueira AA, Poli-Neto OB. Abdominal myofascial pain syndrome must be considered in the differential diagnosis of chronic pelvic pain. Eur J Obstet Gynecol Reprod Biol. 2009 Nov;147(1):21-4. doi: 10.1016/j.ejogrb.2009.06.025. Epub 2009 Jul 22.

    PubMed 19628327
  • Lucas KR, Rich PA, Polus BI. Muscle activation patterns in the scapular positioning muscles during loaded scapular plane elevation: the effects of Latent Myofascial Trigger Points. Clin Biomech (Bristol). 2010 Oct;25(8):765-70. doi: 10.1016/j.clinbiomech.2010.05.006. Epub 2010 Jul 27.

    PubMed 20667633
  • Mishra S, Jain S. Effectiveness of Functional Magnetic Stimulation versus Conventional Physiotherapy in Myofascial Pain Syndrome of Upper Trapezius: Study Protocol for a Randomized Controlled Trial. Int J Latest Technol Eng Manag Appl Sci. 2025 Oct 16;14:776-9. doi:10.51583/IJLTEMAS.2025.1409000091

Questions about this trial

What is this clinical trial studying?

A study testing Group A = Emmett Technique with conventional physiotherapy and Group B = Bowen Technique with conventional physiotherapy in people with Myofascial Pain Syndrome (Upper Trapezius), run by University of Management and Technology Sialkot Pakistan at 1 site in Pakistan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: enrolling by invitation, as of the sponsor's last update on 21 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Numerical Pain Rating Scale (time frame: 6 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07767747, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Aug 2026.

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