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Dry Needling Versus Manual Therapy for Patients With Mechanical Neck Pain: A Randomized Controlled Trial
The Journal of Orthopaedic and Sports Physical Therapy
|January 29, 2024
Summary
Manual therapy plus exercises demonstrated superior short- and intermediate-term effectiveness compared to dry needling plus exercises for mechanical neck pain relief and functional improvement.
Area of Science:
- Orthopedics
- Physical Therapy
- Rehabilitation Medicine
Background:
- Mechanical neck pain is a prevalent condition causing significant disability.
- Current treatment options include manual therapy and dry needling, often combined with therapeutic exercises.
- Comparative effectiveness data for these interventions in the short and intermediate term are crucial for clinical decision-making.
Purpose of the Study:
- To compare the short- and intermediate-term effects of manual therapy plus exercises versus dry needling plus exercises.
- To evaluate the impact on pain, disability, function, and patient-perceived improvement in mechanical neck pain patients.
Main Methods:
- A single-blinded randomized controlled trial involving 78 patients with mechanical neck pain.
- Participants were randomized to receive either manual therapy + exercises (MT + Exercises) or dry needling + exercises (DN + Exercises) for 6 weeks.
- Outcome measures included Neck Disability Index, numeric pain-rating scale, and Patient-Specific Functional Scale, assessed at baseline, 2 weeks, discharge, and 3 months post-discharge.
Main Results:
- Both groups showed significant improvements over time, but the MT + Exercises group demonstrated statistically significant superiority across all outcome measures at all time points.
- The MT + Exercises group exceeded the minimal clinically important difference for pain, disability, and function.
- No significant differences were found between the groups in the Fear-Avoidance Belief Questionnaire or Deep Neck Flexor Endurance Test.
Conclusions:
- Manual therapy combined with therapeutic exercises is more effective than dry needling combined with therapeutic exercises for managing mechanical neck pain.
- This approach leads to greater reductions in pain and disability and improved function in both the short and intermediate term.
- Clinicians should consider manual therapy as a primary treatment strategy for mechanical neck pain.
