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Scar dry needling for tissue compliance in individuals with linear scars: a randomized controlled trial
Mohammadreza Pourahmadi1, Jan Dommerholt1,2,3, Maryam Ahmadi1
1Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
Background:
Evidence for dry needling (DN) in scar management remains limited.
Objective:
To compare scar-DN with minimal needling for tissue compliance, local scar-related pain, passive knee flexion, and health-related quality of life in individuals with linear scars.
Design:
A single-center, assessor-blinded, randomized controlled trial.
Methods:
Eighty participants were randomized to scar-DN or minimal needling away from the scar; both groups also received kinesiology taping and infrared therapy. The primary outcome was tissue compliance at 5-, 10-, and 15-mm indentation depths. Secondary outcomes were local scar-related pain, passive knee flexion in participants with anterior knee scars, and SF-36 physical and mental component scores. Assessments occurred at baseline, post-treatment, and two weeks.
Results:
Compared with minimal needling, scar-DN was associated with greater tissue compliance at the 5-mm depth immediately after treatment (adjusted mean difference [MD], -4.51 N; 95% CI, -6.48 to -2.54), at the 10-mm depth immediately after treatment (-6.24 N; 95% CI, -9.20 to -3.28) and follow-up (-9.84 N; 95% CI, -14.60 to -5.07), and at the 15-mm depth at follow-up (-6.68 N; 95% CI, -10.70 to -2.65). Differences at the remaining depth-time combinations were not statistically significant. No statistically significant or clinically meaningful between-group difference was found in local scar-related pain (n = 28), although this analysis was underpowered because pain was not present in all participants. No significant between-group differences were found in SF-36 physical or mental component scores. Passive knee flexion favored scar-DN, but this exploratory analysis included only 14 participants.
Conclusions:
Scar-DN was associated with short-term improvements in tissue compliance at some indentation depths. The clinical importance and durability of these findings remain uncertain; no between-group differences were identified in local scar-related pain or health-related quality of life.
Clinical Trial Registry Number:
IRCT20130409012953N4, NCT06033430.