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

PainSci » bibliography » Gattie et al 2021
updated
Tags: dry needling, muscle pain, muscle, pain problems, treatment

PainSci commentary on Gattie 2021: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

This is a study of “dry needling,” the practice of lancing trigger points with acupuncture needles. It was a little more powerful than we usually get, and in particular it had good follow-up: they checked with their subjects at 4 weeks, 6 months, and a full year. Seventy-seven people with neck pain were assigned to one of two groups, one with sham needling, and another with the real deal. They all got standard “manual therapy and exercise.” Their conclusion is so clear that it needs no translation:

There were no differences in outcomes between trigger point dry needling and sham dry needling when added to a multimodal treatment program for neck pain. Dry needling should not be part of a first-line approach to managing neck pain.

~ Paul Ingraham

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

Objective: To examine the short- and long-term 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. Design: Randomized controlled trial. 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. Results: There were no group-by-time interactions for disability (Neck Disability Index: F2.37,177.47 = 0.42, P = .69), current pain (visual analog scale: F2.84,213.16 = 1.04, P = .37), or average pain over 24 hours (F2.64,198.02 = 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: F2.37,177.47 = 124.70, P<.001; current pain: F2.84,213.16 = 64.28, P<.001; and average pain over 24 hours: F2.64,198.02 = 76.69, P<.001). Conclusion: There were no differences in outcomes between trigger point dry needling and sham dry needling when added to a multimodal treatment program for neck pain. Dry needling should not be part of a first-line approach to managing neck pain.

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