Comparing Efficacy of Dry Needling Combined with Passive Stretching and Muscle Energy Technique on Myofascial Trigger Points

"Treatment protocol:~1. Dry needling: Prone position, identify trigger points in upper trapezius, use Hong technique with 50mm/0.25 gauge needle, eliciting local twitch response.~2. Passive stretching: Supine position, cervical spine stretched just short of restriction, hold for 30s with 20s rest, repeat 3 times.~3. Muscle Energy Technique: Supine position, identify restriction barrier, move spine away from barrier, instruct patient to isometrically contract opposing movement (25% strength), hold for 7-10s, then stretch towards new barrier for 30s, repeat 3 times."