Acupoint Focused Ultrasound Versus Laserpuncture in Chronic Mechanical Neck Pain

Main Article Content

Rania Nagy Karkousha
Dina Ahmed Ahmed Asar
Maher Ahmed ElKeblawy
Mohammed Abd-Elhalim Kadah


Acupoint focused ultrasound, Laserpuncture, Mechanical neck pain.


Background: Mechanical neck pain typically develops gradually and has a variety of causes, including one or more of the following: neck strain, anxiety, bad posture, and activities related to job or sport. Purpose: The purpose of this research was to evaluate the efficacy of Acupoint focused ultrasound vs Laserpuncture in treating chronic mechanical neck pain, specifically in terms of pain intensity, range of motion, as well as neck function
Subjects and methods: The study comprised 45 individuals (aged 30 – 60) experiencing persistent mechanical neck pain, who were randomly split into three groups of equal size. Group (A) Experimental group got laserpuncture on top of traditional treatment, which entailed neck muscular stretching as well as strengthening Group (B) Experimental group got acupoint focused ultrasound along with traditional treatment and Group (C) Control group got traditional treatment only. All participants will receive treatment for 4 weeks, at a frequency of 3x/week. All patients were examined using a visual analogue scale, digital goniometer, as well as the Copenhagen Neck Function Disability Scale before and also after their rehabilitation programs.
Results: There was no substantial difference in Visual analogue scale, Copenhagen neck function disability scale as well as Neck range of motion among the three groups, pretreatment differences (p > 0.05). There was a substantial improvement in visual analogue scale as well as Copenhagen neck function disability scale of group A when contrasted to group B & C also substantial improvement in group B when contrasted to group C. There was a substantial improvement in neck flexion as well as neck extension range of motion of group A when contrasted to group C also a substantial improvement in neck extension range of motion as well as neck extension of group A when contrasted to group B. There was no substantial difference in right also left neck side bending as well as right and left neck rotation ROM among post-treatment groups (p > 0.05). 

Conclusion: In chronic mechanical neck pain, both laserpuncture and acupoint focused ultrasound are effective modalities for treating chronic mechanical neck pain respectively but Laserpuncture is more effective than acupoint focused ultrasound and conventional treatment in pain, function, neck extension range of motion and also is better than conventional treatment in neck flexion range of motion.

Abstract 222 | PDF Downloads 157


1. Genebra CVDS, Maciel NM, Bento TPF, Simeão SFAP, Vitta A. Prevalence and factors associated with neck pain: a population-based study. Braz J Phys Ther. 2017 Jul-Aug;21(4):274-280.
2. Kazeminasab S, Nejadghaderi SA, Amiri P, Pourfathi H, Araj-Khodaei M, Sullman MJM, Kolahi AA, Safiri S. Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord. 2022 Jan 3;23(1):26.
3. Liang ZH, Di Z, Jiang S, Xu SJ, Zhu XP, Fu WB, Lu AP. The optimized acupuncture treatment for neck pain caused by cervical spondylosis: a study protocol of a multicentre randomized controlled trial. Trials. 2012 Jul 9;13: 107.
4. Huang Z, Ma J, Chen J, Shen B, Pei F, Kraus VB. The effectiveness of low-level laser therapy for nonspecific chronic low back pain: a systematic review and meta-analysis. Arthritis Res Ther. 2015 Dec 15;17: 360
5. Gross AR, Dziengo S, Boers O, Goldsmith CH, Graham N, Lilge L, Burnie S, White R. Low Level Laser Therapy (LLLT) for Neck Pain: A Systematic Review and Meta-Regression. Open Orthop J. 2013 Sep 20;7: 396-419.
6. Peron R, Rampazo ÉP, Liebano RE. Traditional acupuncture and laser acupuncture in chronic nonspecific neck pain: study protocol for a randomized controlled trial. Trials. 2022 May 16;23(1):408.
7. Bier JD, Scholten-Peeters WGM, Staal JB, Pool J, van Tulder MW, Beekman E, Knoop J, Meerhoff G, Verhagen AP. Clinical Practice Guideline for Physical Therapy Assessment and Treatment in Patients with Nonspecific Neck Pain. Phys Ther. 2018 Mar 1;98(3):162-171. 8. Tsuruoka N, Watanabe M, Takayama S, Seki T, Matsunaga T, Haga Y. Brief effect of acupoint stimulation using focused ultrasound. J Altern Complement Med. 2013 May;19(5):416-9.
9. Rossman, Martin L.; Wexler, Jesse; Oyle, Irving (1974). The Use of Sonopuncture in Some Common Clinical Syndromes. The American Journal of Chinese Medicine, 2(2), 199–201.
10. Petterson S, Plancher K, Klyve D, Draper D, Ortiz R. Low-Intensity Continuous Ultrasound for the Symptomatic Treatment of Upper Shoulder and Neck Pain: A Randomized, Double-Blind Placebo-Controlled Clinical Trial. J Pain Res. 2020 Jun 2;13: 1277-1287.
11. Liz Saunders,Laser versus Ultrasound in the Treatment of Supraspinatus Tendinosis: Randomised controlled trial,Physiotherapy,Volume 89, Issue 6, 2003, Pages 365-373.
12. Yavuz F, Duman I, Taskaynatan MA, Tan AK. Low-level laser therapy versus ultrasound therapy in the treatment of subacromial impingement syndrome: a randomized clinical trial. J Back Musculoskelet Rehabil. 2014;27(3):315-20.
13. Demir H, Yaray S, Kirnap M, Yaray K. Comparison of the effects of laser and ultrasound treatments on experimental wound healing in rats. J Rehabil Res Dev. 2004 Sep;41(5):721-8.
14. Skillgate E, Magnusson C, Lundberg M, Hallqvist J. The age- and sex-specific occurrence of bothersome neck pain in the general population--results from the Stockholm public health cohort. BMC Musculoskelet Disord. 2012 Sep 24;13: 185.
15. Nilsen TI, Holtermann A, Mork PJ. Physical exercise, body mass index, and risk of chronic pain in the low back and neck/shoulders: longitudinal data from the Nord-Trondelag Health Study. Am J Epidemiol. 2011 Aug 1;174(3):267-73.
16. Delgado DA, Lambert BS, Boutris N, McCulloch PC, Robbins AB, Moreno MR, Harris JD. Validation of Digital Visual Analog Scale Pain Scoring with a Traditional Paper-based Visual Analog Scale in Adults. J Am Acad Orthop Surg Glob Res Rev. 2018 Mar 23;2(3):088.
17. Aggarwal K, Lamba AK, Faraz F, Tandon S, Makker K. Comparison of anxiety and pain perceived with conventional and computerized local anesthesia delivery systems for different stages of anesthesia delivery in maxillary and mandibular nerve blocks. J Dent Anesth Pain Med. 2018;18(6):367-373.
18. Yaikwawongs, N., Limpaphayom, N., & Wilairatana, V. Reliability of digital compass goniometer in knee joint range of motion measurement. Medical journal of the Medical Association of Thailand.2009 Apr; 92(4), 517-22.
19. Svensson, M., Lind, V., & Löfgren Harringe, M. Measurement of knee joint range of motion with a digital goniometer: A reliability study. Physiotherapy Research International.2019 Apr;24(2), e1765.
20. Correll S, Field J, Hutchinson H, Mickevicius G, Fitzsimmons A, Smoot B. Reliability And Validity Of The Halo Digital Goniometer For Shoulder Range Of Motion In Healthy Subjects. Int J Sports Phys Ther. 2018 Aug;13(4):707-714.
21. Jordan A Manniche C et al. The Copenhagen Functional Disability Scale: A study of reliability and validity. J Manipulative Physiological Therapeutics. 1998; 21: 520-527. 22. Elbeltagy AM, Sayed WHE, Allah SSR. Validity and Reliability of the Arabic Version of the Copenhagen Neck Functional Disability Scale in Neck Pain Patients. Asian Spine J. 2018 Oct;12(5):817-822.
23. Maher A E,Wafaa H. B, Fatma S, Omar T.The Use of Acupuncture, Laserpuncture and Sonopuncture in Treatment of Chronic Lumbar Myofascial Pain Syndrome,Bull.Fac. Ph. Th. Cairo Univ,:Vol 3. No (1) Jan. 1998,pp.93-100.
24. Sun M, Geng G, Chen J, Ma X, Yan M, Liu X, Du J, Cai D, Zheng H, Zhao L, Liang FR. Acupuncture for chronic neck pain with sensitive points: study protocol for a multicentre randomised controlled trial. BMJ Open. 2019 Jul 30;9(7):026904
25. Häkkinen A, Salo P, Tarvainen U, Wirén K, Ylinen J. Effect of manual therapy and stretching on neck muscle strength and mobility in chronic neck pain. J Rehabil Med. 2007 Sep;39(7):575-9.
26. illanueva-Ruiz I, Falla D, Lascurain-Aguirrebeña I. Effectiveness of Specific Neck Exercise for Nonspecific Neck Pain; Usefulness of Strategies for Patient Selection and Tailored Exercise-A Systematic Review With Meta-Analysis. Phys Ther. 2022 Feb 1;102(2):259
27. Graham N, Gross AR, Carlesso LC, Santaguida PL, Macdermid JC, Walton D, Ho E; ICON. An ICON Overview on Physical Modalities for Neck Pain and Associated Disorders. Open Orthop J. 2013 Sep 20;7: 440-60
28. Rubira APFA, Rubira MC, Rubira LA, Comachio J, Magalhães MO, Marques AP. Comparison of the effects of low-level laser and pulsed and continuous ultrasound on pain and physical disability in chronic non-specific low back pain: a randomized controlled clinical trial. Adv Rheumatol. 2019 Dec 17;59(1):57.
29. Mohamed A.A, Asmaa M.A, Abd El-hamid A.A ,Mina N.S. Effect of Ultrasound Versus LowLevel Laser Therapy in Treatment of Postnatal Low Back Pain. Med. J. Cairo Univ., Vol. 86, No. 7, 2018 December: 4125-4135.
30. Jothi Prasanna K., and Nandhini N (2019) 'A Comparison of Low-Level Laser Therapy Versus Ultrasound Therapy in Trigger Point Release for Chronic Tension Headache', International Journal of Current Advanced Research, 08(03), pp. 17627-17632
31. Djavid GE, Mehrdad R, Ghasemi M, Hasan-Zadeh H, Sotoodeh-Manesh A, Pouryaghoub G. In chronic low back pain, low level laser therapy combined with exercise is more beneficial than exercise alone in the long term: a randomised trial. Aust J Physiother. 2007;53(3):155-60
32. Chow RT, Johnson MI, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet. 2009 Dec 5;374(9705):1897-908.
33. Yılmaz M, Eroglu S, Dundar U, Toktas H. The effectiveness of high-intensity laser therapy on pain, range of motion, functional capacity, quality of life, and muscle strength in subacromial impingement syndrome: a 3-month follow-up, double-blinded, randomized, placebo-controlled trial. Lasers Med Sci. 2022 Feb;37(1):241-250
34. Celik O, Ketenci A, Esmaeilzadeh S, et al.The effectiveness of therapeutic ultrasound in non-specific mechanical cervical pain and comparison of different application methods for clinical practice Annals of the Rheumatic Diseases 2013;72:A992.
35. Qing W, Shi X, Zhang Q, Peng L, He C, Wei Q. Effect of Therapeutic Ultrasound for Neck Pain: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil. 2021 Nov;102(11):2219-2230
36. K. Kotteeswaran, Syed Gaffar, Krishna. R, Keerthana Priya. R. Effectiveness of Laser Therapy and Ultrasound Therapy along with Muscle Energy Technique in subjects with Trapezitis. Asian Journal of Pharmacy and Technology. 2021; 11(2):116-0
37. Noori SA, Rasheed A, Aiyer R, Jung B, Bansal N, Chang KV, Ottestad E, Gulati A. Therapeutic Ultrasound for Pain Management in Chronic Low Back Pain and Chronic Neck Pain: A Systematic Review. Pain Med. 2020 Nov 7;21(7):1482-1493.
38. Rastgar Koutenaei F, Mosallanezhad Z, Naghikhani M, Ezati K, Biglarian A, Nouroozi M, et al. The Effect of Low Level Laser Therapy on Pain and Range of Motion of Patients With Knee Osteoarthritis. Physical Treatments. 2017; 7(1):13-28.
39. Malik S, Sharma S, Dutta N, Khurana D, Sharma RK, Sharma S. Effect of low-level laser therapy plus exercise therapy on pain, range of motion, muscle strength, and function in knee osteoarthritis - a systematic review and meta-analysis. Somatosens Mot Res. 2023 Mar;40(1):8-24.