Effectiveness of Addition of Dry Needling of Upper Trapezius Muscle to Usual Physiotherapy in Management of Chronic Neck Pain: A Randomized Controlled Trial

Research Objectives: To evaluate the effectiveness of adding dry needling (DN) on active MTrPs in the upper trapezius muscle to usual physiotherapy among individuals suffering from chronic neck pain.

Design: A randomized controlled trial.

Setting: This trial was conducted in a private clinic in Saudi Arabia between August 2021 and August 2022. This study was developed and reported following the CONSORT statement and approved by the research ethics committee at Taif University (Application No. 44-004). The study protocol was registered at ClinicalTrials.gov (ID: NCT05614830) prior to the start of subject recruitment. All participants provided informed consent.

Participants: A total of 30 individuals were enrolled and successfully completed the trial. Participants had to have active trigger points associated with neck discomfort within the trapezius muscle lasting for a minimum of 3 months.

Interventions: Subjects were randomized into two groups: experimental group (application of DN on the MTrPs coupled with usual physiotherapy (n=15)), and control group (usual physiotherapy alone (n=15)). The usual physiotherapy program consisted of four sessions over two weeks (2 sessions/week) and included hot packs, active ROM exercises, isometric and self-stretch exercises for neck muscles, cervical extension self-mobilization exercise using a strap. The DN was applied over four sessions in two weeks (2 sessions/week).

Main Outcome Measures: The primary outcomes were pain (assessed by Visual Analogue Scale) and disability (Neck Disability Index); and the secondary outcomes were neck active range of motion (AROM; assessed by cervical ROM) and depression (Beck’s Depression Inventory). All the outcomes were assessed at week 0 (baseline), week 3 (immediately post-intervention) and at week 7 (post-randomization follow-up).

Results: Immediately post-intervention, the experimental group had significantly higher pain (mean difference=1.27, 95% CI 0.20, 2.33, p=0.022, Cohen’s d=0.889), compared with the control group. At 7-weeks post-randomization follow-up, the experimental group had significantly lower disability (mean difference=-3.13, 95% CI -5.07, -1.20, p=0.003, Cohen’s d=1.211), compared with the control group. Compared with the control group, the experimental group had better flexion AROM immediately post-intervention, and better extension, flexion, and right/left side bending, and lower depression at 7-weeks follow-up.

Conclusions: The addition of DN to usual physiotherapy was effective in improving disability, AROM (extension, flexion, and side bending), and depression among patients with chronic neck pain.

Author(s) Disclosures: None.