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Dry needling adds no benefit to the treatment of neck pain: a sham-controlled randomized clinical trial with 1-year follow-up [with consumer summary]
Gattie E, Cleland JA, Pandya J, Snodgrass S
The Journal of Orthopaedic and Sports Physical Therapy 2021 Jan;51(1):37-45
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; 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*

OBJECTIVE: To examine the short- and long-term effectiveness of dry needling on disability, pain, and patient-perceived improvements in patients with mechanical neck pain when added to a multimodal treatment program that includes manual therapy and exercise. DESIGN: Randomized controlled trial. METHODS: Seventy-seven adults (mean +/- SD age, 46.68 +/- 14.18 years; 79% female) who were referred to physical therapy with acute, subacute, or chronic mechanical neck pain were randomly allocated to receive 7 multimodal treatment sessions over 4 weeks of (1) dry needling, manual therapy, and exercise (needling group); or (2) sham dry needling, manual therapy, and exercise (sham needling group). The primary outcome of disability (Neck Disability Index score) and secondary outcomes of pain (current and 24-hour average) and patient-perceived improvement were assessed at baseline and follow-ups of 4 weeks, 6 months, and 1 year by blinded assessors. Between-group differences were analyzed with a 2-way, repeated-measures analysis of variance. Global rating of change was analyzed with a Mann-Whitney U test. RESULTS: There were no group-by-time interactions for disability (Neck Disability Index F[2.37,177.47] = 0.42, p = 0.69), current pain (visual analog scale F[2.84,213.16] = 1.04, p = 0.37), or average pain over 24 hours (F[2.64,198.02] = 0.01, p = 0.10). There were no between-group differences for global rating of change at any time point (p >= 0.65). Both groups improved over time for all variables (Neck Disability Index F[2.37,177.47] = 124.70, p < 0.001; current pain F[2.84,213.16] = 64.28, p < 0.001; and average pain over 24 hours: F[2.64,198.02] = 76.69, p < 0.001). CONCLUSION: There were no differences in outcomes between trigger point dry needling and sham dry needling when added to a multimodal treatment program for neck pain. Dry needling should not be part of a first-line approach to managing neck pain.

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