Dry Needling Adds No Benefit to the Treatment of Neck Pain: A Sham-Controlled Randomized Clinical Trial With 1-Year Follow-up

Abstract

neck pain. 42,47 The most effective physical therapy treatments for neck pain include exercises that strengthen the neck, scapulothoracic region, and shoulder 32 and manipulation and mobilization of the thoracic spine. 30 However, there is conflicting evidence on whether these interventions are more effective when combined or used alone. 16,23,31 Dry needling is a common treatment for musculoskeletal conditions such as neck pain, despite a lack of clinical trials examining its effectiveness. 17,18,24,25,34 Dry needling by physical therapists typically targets myofascial trigger points (MTrPs)-focal, hypersensitive spots in a palpable taut band of muscle. 19,26 Myofascial trigger points are prevalent in patients with neck pain and are associated with range-of-motion restriction, neck pain, headache, and dizziness. 6,21,22,41 Emerging evidence suggests that dry needling of MTrPs may be effective in the short term and medium term to treat neck pain and other musculoskeletal conditions, but there is a lack of studies that have captured long-term outcomes. 7,26,37,38,40,44,50 The primary purpose of our trial was to examine the short-and long-S ymptoms of mechanical neck pain can persist for at least 1 year. 13 Neck pain was ranked ninth for females and 11th for males for years lived with disability in the 2017 Global Burden of Disease study. 28 With increasing costs U OBJECTIVE: To examine the short-and longterm effectiveness of dry needling on disability, pain, and patient-perceived improvements in patients with mechanical neck pain when added to a multimodal treatment program that includes manual therapy and exercise.U DESIGN: Randomized controlled trial.U METHODS: Seventy-seven adults (mean ± SD age, 46.68 ± 14.18 years; 79% female) who were referred to physical therapy with acute, subacute, or chronic mechanical neck pain were randomly allocated to receive 7 multimodal treatment sessions over 4 weeks of (1) dry needling, manual therapy, and exercise (needling group); or (2) sham dry needling, manual therapy, and exercise (sham needling group). The primary outcome of disability (Neck Disability Index score) and secondary outcomes of pain (current and 24-hour average) and patient-perceived improvement were assessed at baseline and follow-ups of 4 weeks, 6 months, and 1 year by blinded assessors. Between-group differences were analyzed with a 2-way, repeated-measures analysis of variance. Global rating of change was analyzed with a Mann-Whitney U test.U RESULTS: There were no group-by-time interactions for disability (Neck Disability Index: F 2.37,177.47 = 0.42, P = .69), current pain (visual analog scale: F 2.84,213.16 = 1.04, P = .37), or average pain over 24 hours (F 2.64,198.02 = 0.01, P = .10). There were no between-group differences for global rating of change at any time point (P≥.65). Both groups improved over time for all variables (Neck Disability Index:

Rapid Improvement in Neck Disability, Mobility, and Sleep Quality with Chronic Neck Pain Treated by Fu’s Subcutaneous Needling: A Randomized Control Study

“…Needle therapy, including dry needling, for chronic neck pain is usually used with more than one filament needle to needle into the MTrPs directly or nearby areas; however, the effectiveness of dry needling on chronic neck pain is equivocal, recently reported by a long-term follow-up trial [ 37 ] and a meta-analysis study [ 38 ]. Furthermore, given that most people are high responders to needle pain [ 39 ], remote therapy and needle-less methods are the better options for health care.…”

Short-Term Effects of Dry Needling with a Standard Exercise Program on Pain and Quality of Life in Patients with Chronic Mechanical Neck Pain

“…The current study results agree with those of previous studies that compared the efficacy of DN with that of other interventions for CMNP. A recent randomised controlled trial (RCT) by Gattie, Cleland [ 42 ] on the efficacy of DN and manual therapy (MT) in CMNP revealed that MTrP-DN showed no substantial or clinically meaningful advantages in disability reduction or pain alleviation compared to MT and exercise in both short term and long-term follow-ups. Onat, Polat [ 1 ] compared the efficacy of DN and kinesio-tape in mechanical neck pain and found that the latter was superior to DN in improving the flexibility of the neck region and reducing the disability of CMNP patients.…”

Effects of dry needling of the obliquus capitis inferior on sensorimotor control and cervical mobility in people with neck pain: A double-blind, randomized sham-controlled trial

“…Current evidence does not support a long-term added benefit of DN to traditional therapeutic modalities for neck pain. 76,77 Thus, it should be explored if the addition of DN to tailored sensorimotor training can provide additional gains in sensorimotor control measures. Also, a reduction in pain intensity (which was close to be clinically meaningful) was observed after DN; which is consistent with previous studies targeting the local source of altered cervical afferent input in people with neck pain and impaired sensorimotor function.…”