Detailed Search Results
| Author/Association: | Stieven FF, Ferreira GE, Wiebusch M, de Araujo FX, da Rosa LHT, Silva MF |
| Title: | Dry needling combined with guideline-based physical therapy provides no added benefit in the management of chronic neck pain: a randomized controlled trial [with consumer summary] |
| Source: | The Journal of Orthopaedic and Sports Physical Therapy 2020 Aug;50(8):447-454 |
| Method: | clinical trial |
| Method Score: | 8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
| Consumer Summary: | KEY POINTS: FINDINGS: One month of guideline-based physical therapy plus dry needling improved pain in the short term (1 month), but not in the long term (6 months). There was no effect on disability in people with chronic neck pain. IMPLICATIONS: Owing to the small, clinically unimportant reduction in pain only in the short term, clinicians should not consider dry needling in addition to physical therapy as a treatment for chronic neck pain. CAUTION: Only 3 therapists delivered interventions in both groups, which may limit the potential to generalize results. Improvements observed in both groups could be explained by the natural course of neck pain. |
| Abstract: | OBJECTIVE: 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 previous week, measured with a numeric pain-rating scale (0 to 10), and disability, measured with the Neck Disability Index (0 to 100). The secondary outcomes were pain and disability measured at 3 and 6 months post randomization and global perceived effect, quality of sleep, pain catastrophizing, and self-efficacy measured at 1, 3, and 6 months post randomization. RESULTS: One hundred sixteen participants were recruited. At 1 month post randomization, people who received guideline-based physical therapy plus dry needling had a small reduction in average pain intensity in the previous 24 hours (mean difference, 1.56 points; 95% confidence interval (CI) 1.11 to 2.36) and in the previous week (mean difference 1.20 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 -3.01 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. Full text (sometimes free) may be available at these link(s):  help |
