Dry Needling Adds No Benefit to the Treatment of Neck Pain: A Sham-Controlled Randomized Clinical Trial With 1-Year Follow-up
Two articles on PainSci cite Gattie 2021: 1. The Complete Guide to Trigger Points & Myofascial Pain 2. The Complete Guide to Neck Pain & Cricks
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. All studies are flawed, but this one is refreshingly powerful for this sort of thing, and good in several ways: seventy-seven folks with neck pain were assigned to one of two groups, one with sham needling, and another with the real deal. Everyone got standard “manual therapy and exercise.” There was no ideal control group (a sham-only group), which is a weakness but not a deal-breaker. But there was particularly good follow-up: subjects were checked at 4 weeks, 6 months, and a full year. Nice work.
And the results? The conclusion of this scientific paper 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.”
Alrighty, then! That is quite clear.
~ 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.
- “No Added Benefit of Combining Dry Needling With Guideline-Based Physical Therapy When Managing Chronic Neck Pain: A Randomized Controlled Trial,” Stieven et al, Journal of Orthopaedic & Sports Physical Therapy, 2020.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Inciting events associated with lumbar disc herniation. Suri 2010 Spine J.
- Prediction of an extruded fragment in lumbar disc patients from clinical presentations. Pople 1994 Spine (Phila Pa 1976).
- Characteristics of patients with low back and leg pain seeking treatment in primary care: baseline results from the ATLAS cohort study. Konstantinou 2015 BMC Musculoskelet Disord.
- Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial. Kuyken 2022 Evid Based Ment Health.
- No long-term effects after a three-week open-label placebo treatment for chronic low back pain: a three-year follow-up of a randomized controlled trial. Kleine-Borgmann 2022 Pain.