Immediate effects of dry needling and acupuncture at distant points in chronic neck pain: results of a randomized, double-blind, sham-controlled crossover trial

Abstract

To evaluate immediate effects of two different modes of acupuncture on motion-related pain and cervical spine mobility in chronic neck pain patients compared to a sham procedure. Thirty-six patients with chronic neck pain and limited cervical spine mobility participated in a prospective, randomized, double-blind, sham-controlled crossover trial. Every patient was treated once with needle acupuncture at distant points, dry needling (DN) of local myofascial trigger points and sham laser acupuncture (Sham). Outcome measures were motion-related pain intensity (visual analogue scale, 0-100 mm) and range of motion (ROM). In addition, patients scored changes of general complaints using an 11-point verbal rating scale. Patients were assessed immediately before and after each treatment by an independent (blinded) investigator. Multivariate analysis was used to assess the effects of true acupuncture and needle site independently. For motion-related pain, use of acupuncture at non-local points reduced pain scores by about a third (11.2 mm; 95% CI 5.7, 16.7; P = 0.00006) compared to DN and sham. DN led to an estimated reduction in pain of 1.0 mm (95% CI -4.5, 6.5; P = 0.7). Use of DN slightly improved ROM by 1.7 degrees (95% CI 0.2, 3.2; P = 0.032) with use of non-local points improving ROM by an additional 1.9 degrees (95% CI 0.3, 3.4; P = 0.016). For patient assessment of change, non-local acupuncture was significantly superior both to Sham (1.7 points; 95% CI 1.0, 2.5; P = 0.0001) and DN (1.5 points; 95% CI 0.4, 2.6; P = 0.008) but there was no difference between DN and Sham (0.1 point; 95% CI -1.0, 1.2; P = 0.8). Acupuncture is superior to Sham in improving motion-related pain and ROM following a single session of treatment in chronic neck pain patients. Acupuncture at distant points improves ROM more than DN; DN was ineffective for motion-related pain.

Clinical Effectiveness of Dry Needling Immediately After Application on Myofascial Trigger Point in Upper Trapezius Muscle

“…14,15 Although some previous studies have assessed the effect of DN on MTP in UT muscles, a review of the published reports determined that some randomized clinical trials have been conducted to determine the effectiveness of DN in the treatment of MTP in UT muscle. [16][17][18][19][20][21] However, with the use of different designs, samples, and testing procedures, controversial results have been reported regarding the effect of DN on MTP in UT muscles. [16][17][18][19][20][21] Most of the previous studies have assessed the clinical effectiveness of DN immediately after treatment procedures.…”

“…[16][17][18][19][20][21] However, with the use of different designs, samples, and testing procedures, controversial results have been reported regarding the effect of DN on MTP in UT muscles. [16][17][18][19][20][21] Most of the previous studies have assessed the clinical effectiveness of DN immediately after treatment procedures. 17,[19][20][21] Muscle soreness is a common report after DN application.…”

“…[16][17][18][19][20][21] Most of the previous studies have assessed the clinical effectiveness of DN immediately after treatment procedures. 17,[19][20][21] Muscle soreness is a common report after DN application. 20 Typically, after DN technique the muscle soreness lasts and may be felt for a few hours up to 24 to 48 hours.…”

“…17,[19][20][21] Muscle soreness is a common report after DN application. 20 Typically, after DN technique the muscle soreness lasts and may be felt for a few hours up to 24 to 48 hours. 20 Considering this soreness after DN, the results collected immediately after treatment, such as pain intensity and pressure pain threshold (PPT), may be affected by soreness caused by needle insertion to the muscle.…”

“…20 Typically, after DN technique the muscle soreness lasts and may be felt for a few hours up to 24 to 48 hours. 20 Considering this soreness after DN, the results collected immediately after treatment, such as pain intensity and pressure pain threshold (PPT), may be affected by soreness caused by needle insertion to the muscle. Because of the risk of muscle soreness, assessment of only immediate effects of DN can be criticized, and the results from the studies that measured the variables immediately after needling should be interpreted with caution.…”