Neck Pain Clinical Trial
Official title:
The Influence of Patient Expectation in Dry Needling Induced Analgesia
This study will evaluate placebo mechanisms related to dry needling(DN) trying to determinate whether an additive effect occurs when DN is provided with an instructional set known to enhance placebo analgesia. External manipulation of patient expectation for receiving DN will be performed, in a similar way as has been already done in studies investigating the influence of expectation on spinal manipulative therapy interventions. The main purpose of this study will be therefore to determine, for the first time, how subjects' expectation about the effect of DN influences the resultant hypoalgesia. Analgesic effects of DN will be assessed using the conditioned pain modulation (CPM) paradigm, which has not been previously evaluated in relation to DN.
Just before DN intervention, participants will receive a positive or a neutral expectation
instructional set regarding effects of a DN technique on pain perception. This instructional
set will be randomly allocated to each patient.
Participants in the positive expectation group will be told that DN procedure: "is a very
effective form of treatment used to treat neck-shoulder pain and it is expected to reduce
your perception of pressure pain". Participants in the neutral expectation group will be told
that DN procedure: "is a form of treatment used to treat neck-shoulder pain that has unknown
effects on your perception of pressure pain".
DN intervention An experienced and trained physical therapist will provide DN to all the
subjects. This researcher will be blinded to the specific expectation instructional set the
participant receives. Participants will receive one session of DN treatment for the active
Myofascial Trigger Points(MTrP) located at the upper trapezius muscle. They will be placed in
a prone position on the examination table. Solid filament needles of 0.30 mm diameter and 40
mm length will be used. The needle will be inserted into the skin over the palpated MTrP
using pincer palpation, and slowly advanced perpendicularly until it reaches the MTrP and a
twitch response is elicited.
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