Muscle Position and Dry Needling Efficacy

Official title

The Importance of Muscle Position in the Effectiveness of Dry Needling Technique

Overview

Currently, no previous studies have investigated how the position of a muscle before dry needling may influence the outcome and effectiveness of the treatment. This study aims to demonstrate whether the position of the upper trapezius muscle during dry needling treatment influences the outcome of that treatment in subjects with neck pain. A total of 46 participants with chronic neck pain will be recruited and randomly assigned to two groups: a dry needling group with the muscle in a stretched position and a dry needling group with the muscle in a shortened position. A total of two treatment sessions will be performed, separated by a 7-day interval. The primary outcome measure will be the intensity of neck and head pain, measured using the visual analog scale (VAS). Other variables to be measured include the cervical disability index, kinesiophobia, and catastrophizing (using a self-completion questionnaire), as well as participants' expectations and post-needling pain.

Interventions

• Other Dry needling technique with the shoulder in full adduction.
  Ten incisions will be made in a posteroanterior direction while the patient lies prone and the muscle is grasped with a pincer grip between the first three fingers. The technique will be applied to the area that is mechanically most hyperalgesic and related to the reproduction of the patient's pain.
• Other Dry needling technique with the shoulder in 90° abduction.
  Ten incisions will be made in a posteroanterior direction while the patient lies prone and the muscle is grasped with a pincer grip between the first three fingers. The technique will be applied to the area that is mechanically most hyperalgesic and related to the reproduction of the patient's pain.

Primary outcome measures

• The visual analog scale (VAS) [Time frame: Change from baseline at 3 months]

Secondary outcome measures (5)

• Disability Associated with Neck Pain [Time frame: Change from baseline at 3 months]
• Kinesiophobia with the Tampa Kinesiophobia Scale (TSK-11) [Time frame: Change from baseline at 3 months]
• Catastrophizing with the Pain Catastrophizing Scale (PCS) [Time frame: Change from baseline at 3 months]
• Local twitch response (LTRs) [Time frame: Change from baseline at 3 months]
• Cervical joint Range [Time frame: Change from baseline mobility at one week after intervention]

Eligibility criteria

Inclusion criteria

• Age between 18 and 65 years
• Neck pain lasting more than 3 months
• Current neck pain greater than 3/10 on the VAS (Visual Analog Scale)
• Presence of active trigger points in the upper trapezius muscle, meeting the following criteria: Painful point within a taut band whose palpation reproduces the patient's symptoms.

Exclusion criteria

• Neck pain with a medical diagnosis (fractures, arthritis, fibromyalgia, etc.)
• Radicular pain (paresthesia, burning, electric shocks)
• Whiplash or any recent trauma
• Previous surgery
• Treatment by another physiotherapist within the last 3 months
• Infections
• Needle phobia
• Use of anticoagulant medications
• Pregnancy
• Fibromyalgia
• Metal allergies
• Cognitive deficits or communication problems

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Double blind

Primary purpose

Treatment

Study locations

Spain · 2 centers

• Clinical University Physiotherapy and pain — Alcalá de Henares
• Physioterapy and Pain center research — Alcalá de Henares

Identifiers

NCT: NCT07629141 · CEEI22/199

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗