PainSci summary of Stieven 2020?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 at the bottom of the page, as often as possible. ★★★★☆4-star ratings are for bigger/better studies and reviews published in more prestigious journals, with only quibbles. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.
This study was designed well and 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. Their sad conclusion: “Dry needling resulted in small improvements in pain only at 1 month post-randomization. There was no effect on disability.”
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.
These two articles on PainScience.com cite Stieven 2020 as a source:
- Save Yourself from Neck Pain! — A complete guide to chronic neck pain and the disturbing sensation of a “crick”
- Science versus Experience in Musculoskeletal Medicine — The conflict between science and clinical experience and pragmatism in the management of aches, pains, and injuries
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:
- Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial. Munteanu 2015 Br J Sports Med.
- A Bayesian model-averaged meta-analysis of the power pose effect with informed and default priors: the case of felt power. Gronau 2017 Comprehensive Results in Social Psychology.
- The neck and headaches. Bogduk 2014 Neurol Clin.
- Agreement of self-reported items and clinically assessed nerve root involvement (or sciatica) in a primary care setting. Konstantinou 2012 Eur Spine J.
- Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. Morelli 2017 Am J Sports Med.