Dry Needling Plus Manual Therapy and Exercise for Subacromial Pain Syndrome: A Sham-Controlled Randomized Clinical...

Area of Science:

• Orthopedics
• Physical Therapy
• Pain Management

Background:

• Subacromial pain syndrome (SAPS) is a common cause of shoulder pain.
• Exercise and manual therapy are standard treatments for SAPS.
• The added benefit of dry needling to these treatments requires further investigation.

Purpose of the Study:

• To evaluate the effect of adding dry needling to exercise and manual therapy on Shoulder Pain and Disability Index (SPADI) scores in individuals with SAPS.
• To assess secondary outcomes including physical function, pain interference, patient acceptable symptom state (PASS), and healthcare utilization.

Main Methods:

• A three-arm randomized trial with 121 participants diagnosed with SAPS.
• Participants were assigned to physical therapy (PT) only, PT with sham dry needling (PT+SDN), or PT with dry needling (PT+DN).
• Primary outcome was SPADI at 1 year; secondary outcomes included PROMIS-57 subscales, PASS, and healthcare use.

Main Results:

• No statistically significant differences in SPADI scores at 1 year between the PT+DN group and either the PT Only or PT+SDN groups.
• Significant improvements in PASS were observed in the PT+DN group compared to both control groups at 6 months and 1 year (vs PT+SDN).
• Participants receiving PT+DN reported significantly less additional shoulder-related healthcare use at 1 year (OR = 0.35).

Conclusions:

• Dry needling, when added to a standard physical therapy program, did not lead to superior SPADI score improvements for SAPS at one year.
• While not improving the primary outcome, dry needling showed potential clinical value through enhanced patient-perceived symptom acceptability and reduced healthcare utilization.
• Further research may explore optimal integration of dry needling within multimodal SAPS treatment protocols.