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

Journal of Orthopaedic & Sports Physical Therapy
Published Online:April 9, 2020 Volume0 Issue0 Pages1-21
https://www.jospt.org/doi/10.2519/jospt.2020.9389

Abstract
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. J Orthop Sports Phys Ther, Epub 9 Apr 2020. doi:10.2519/jospt.2020.9389

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