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No Added Benefit of Combining Dry Needling With Guideline-Based Physical Therapy When Managing Chronic Neck Pain: A Randomized Controlled Trial


Tags: treatment, dry needling, neck, bad news, muscle pain, muscle, pain problems, head/neck, spine

Four articles on PainSci cite Stieven 2020: (1) The Complete Guide to Trigger Points & Myofascial Pain(2) The Complete Guide to Headaches(3) The Complete Guide to Neck Pain & Cricks(4) Science versus Experience in Musculoskeletal Medicine

PainSci summary of Stieven 2020: ?This page is one of thousands in the 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 at the bottom of the page, as often as possible.

This study was designed well, and it’s powerful enough to be persuasive. It compared standard guideline-based physio to a combination of that with dry needling in more than a hundred patients, with follow-up at 1, 3, and 6 months. Their sad conclusion: “Dry needling resulted in small improvements in pain only at 1 month post-randomization. There was no effect on disability.”

~ 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.

OBJECTIVES: To determine the added benefit of combining dry needling with a guideline-based physical therapy treatment program consisting of exercise and manual therapy on pain and disability in people with chronic neck pain.

DESIGN: Randomized controlled trial.

METHODS: Participants were randomized to receive either guideline-based physical therapy or guideline-based physical therapy plus dry needling. The primary outcomes, measured at 1 month post-randomization, were: average pain intensity (in the previous 24 hours and in the previous week) measured with a numerical pain rating scale (0-10), and disability measured with the Neck Disability Index (0-100). The secondary outcomes were pain and disability measured at 3 and 6 months, and global perceived effect, quality of sleep, pain catastrophizing, and self-efficacy measured at 1, 3 and 6 months.

RESULTS: 116 participants were recruited. At one month post-randomization, people who received dry needling plus guideline-based physical therapy had a small reduction in average pain intensity in the previous 24 hours (mean difference: 1.56 points; 95% CI 1.11 to 2.36), and average pain intensity in the previous week (mean difference: 1.49 points; 95% CI 1.02 to 2.21). There was no effect of adding dry needling to guideline-based physical therapy on disability at 1-month post-randomization (mean difference: -2.08 points; 95% CI -1.16 to 5.07). There was no effect for any of the secondary outcomes.

CONCLUSION: When combined with guideline-based physical therapy for neck pain, dry needling resulted in small improvements in pain only at 1 month post-randomization. There was no effect on disability.

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: