Neck Pain Clinical Trial
Official title:
Dry Needling for Patients With Neck Pain: A Randomized Clinical Trial
The aim of this trial will be to examine the short and long term effectiveness of dry needling on pain, disability, and patient perceived improvements in patients with neck pain attending physical therapy. The investigators hypothesize that patients who receive dry needling, manual therapy, and exercise will achieve greater reductions in pain and disability in the short (4 weeks) and long term (6 and 12 months) compared to those who receive sham dry needling, manual therapy, and exercise.
Background: Neck pain is a costly and common problem. Current treatments are not adequately
effective for a large proportion of patients who continue to experience recurrent pain.
Therefore, new treatment strategies should be investigated in an attempt to reduce the
disability and high costs associated with neck pain.
Dry needling is a technique in which a fine needle is used to penetrate the skin,
subcutaneous tissues, and muscle with the intent to mechanically disrupt tissue without the
use of an anesthetic. Dry needling is emerging as a treatment modality that is widely used
clinically to address a variety of musculoskeletal conditions. Recent studies of dry needling
in mechanical neck pain have shown decreased pain, increased pain pressure threshold,
improved range of motion, and decreased disability in the short term. The majority of these
studies examined dry needling using methods atypical to clinical practice (dry needling as a
sole treatment, or fewer visits than is common practice). None included long-term follow up.
A clinical trial with realistic treatment time frames and methods consistent with clinical
practice is needed to examine the effectiveness of dry needling on reducing pain and
enhancing function in patients presenting with mechanical neck pain.
Purpose: The aim of this trial will be to examine the short and long term effectiveness of
dry needling on pain, disability, and patient perceived improvements in patients with neck
pain.
Design: The investigators will conduct a randomized single blind placebo controlled trial in
accordance with the CONSORT guidelines. All patients with mechanical neck pain referred to
physical therapy will be screened for eligibility criteria. Participants will be randomized
to receive 1) dry needling, manual therapy, and exercise or 2) sham dry needling, manual
therapy and exercise. Participants will receive 7 treatments over a maximum of 4 weeks.
Methods: The primary outcome will be disability as measured by the Neck Disability Index.
Pain and patient perceived improvement will also be recorded. Outcome measures will be
assessed at 4 weeks, 6 months, and 12-months by an assessor who is blind to the group
allocation of the participants to determine the short and long-term treatment effects.
Data Analysis: The investigators will examine the primary aim with a 2-way repeated-measures
analysis of variance (ANOVA) with treatment group as the between subject variable and time as
the within-subjects variable. The hypothesis of interest will be the 2-way group by time
interaction.
Significance: The successful completion of this trial will provide evidence to demonstrate
whether dry needling is effective for the management of mechanical neck pain when used in a
combined treatment approach as is commonly practiced clinically.
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