Overview

This study ill include four treatment groups. Group A who will receive traditional physical therapy, group B who will receive INIT plus traditional physical therapy , group C who will receive dry cupping therapy plus traditional physical therapy or group D will receive Dry needling therapy plus traditional physical therapy . All groups completed 4 weeks of intervention.

Eligibility

Inclusion Criteria:

• Medically competent men and women will be included They had chronic MTrPs in the upper trapezius for more than 6 months Diagnostic criteria of being a tight band with a palpable nodule and distant pain when subjected to pressure

Exclusion Criteria:

• subjects with previous neck or shoulder pathology (e.g., fracture, sur¬gery, inflammatory and infectious diseases), cervical disc pathology, systemic disorder, fibromyalgia, those who underwent physical therapy for at least the previous 3 months