Comparison of Dry Needling versus Orthopedic Manual Therapy in Patients with Myofascial Chronic Neck Pain: A Single-Blind, Randomized Pilot Study

Abstract

Objective. The aim of this study was to compare the efficacy of three interventions for the treatment of myofascial chronic neck pain. Methods. Thirty-six patients were randomly assigned to one of three intervention groups: orthopedic manual therapy (OMT), dry needling and stretching (DN-S), and soft tissue techniques (STT). All groups received two treatment sessions with a 48 h time interval. Outcome measures included neck pain intensity measured using a visual analogue scale, cervical range of motion (ROM), pressure pain threshold for measuring mechanical hyperalgesia, and two self-reported questionnaires (neck disability index and pain catastrophizing scale). Results. The ANOVA revealed significant differences for the group × time interaction for neck disability, neck pain intensity, and pain catastrophizing. The DN-S and OMT groups reduced neck disability. Only the OMT group showed decreases in mechanical hyperalgesia and pain catastrophizing. The cervical ROM increased in OMT (i.e., flexion, side-bending, and rotation) and DN-S (i.e., side-bending and rotation) groups. Conclusions. The three interventions are all effective in reducing pain intensity. Reduction in mechanical hyperalgesia and pain catastrophizing was only observed in the OMT group. Cervical ROM improved in the DN-S and OMT groups and also neck disability being only clinically relevant for OMT group.

Multimodal Care in the Management of a Patient With Chronic Tendinopathy of the Biceps Femoris: A Case Report

“…12 Research suggests that dry needling techniques can help alleviate chronic musculoskeletal pain. 7,13,14 Our data reinforce this assertion and indicate that dry needling may be effective in the treatment of tendinopathy as well. In our patient, the pain experienced with resisted hip extension and knee flexion and active stretching of the legs was resolved at the end of the treatment period and relief was maintained without treatment for the 3-week follow-up period.…”

The Effectiveness of Trigger Point Dry Needling for Musculoskeletal Conditions by Physical Therapists: A Systematic Review and Meta-analysis

“…After the full review process, 12 studies were selected for inclusion. 2,7,12,24,27,28,32,33,35,36,38,43 After contact with primary authors of included studies, 1 further study was identified for inclusion, 6 resulting in a total of 13 studies. The absolute degree of rater agreement for the first and second stages of the study selection was 86% and 93%, respectively.…”

“…This systematic review focused on musculoskeletal pain and included 13 studies: 6 on neck pain (5 on mechanical neck pain 6,24,28,32,43 and 1 on chronic whiplash-associated disorder 38 ), 1 on postoperative shoulder pain, 2 1 on chronic lower back pain, 33 1 on total knee arthroplasty, 27 1 on chronic ankle instability, 35 2 on myofascial pain, 12,36 and 1 on fibromyalgia. 7 Inclusion and exclusion criteria varied greatly across the studies.…”

“…Eight studies 2,6,12,24,33,35,36,43 examined the immediate to 12-week effects of dry needling, and 6 were able to be included in meta-analyses to determine the effect on pain (FIGURE 8). There is moderate-quality evidence suggesting a small effect 8 (SMD, -0.43; 95% CI: -0.77, -0.10) favoring dry needling over other treatment.…”

“…Four studies 6,12,24,43 examined the immediate to 12-week effects of dry needling on PPT compared to other treatments and were meta-analyzed (FIG-URE 9). There is very low-quality evidence suggesting a moderate effect (SMD, 0.61; 95% CI: 0.08, 1.14) favoring dry needling over other treatment.…”