J Man Manip Ther. 2025 Nov 29:1-10. doi: 10.1080/10669817.2025.2591677. Online ahead of print.

ABSTRACT

OBJECTIVE: Clinical guidelines recommend combining exercise with other interventions, including dry needling (DN), for chronic neck pain (NP). The aim was to compare the effects of adding DN, applied locally or distant to the myofascial trigger point (MTrP) site location, to home exercise (HE) on pain, disability, and pressure pain sensitivity for chronic mechanical NP.

METHODS: A single-blind parallel randomized controlled trial was conducted, including 68 adults (78.7% females, mean age: 47 ± 8.2 years) with chronic NP. All participants were assigned to one of the four groups: local DN + HE; distant DN + HE; sham DN + HE; or HE alone. A 12-week HE program was combined with three DN sessions over 4 weeks. The primary outcome was pain intensity at rest in neutral position, highest pain during cervical rotation and in the last 24 h, and pain in the previous week. The arithmetic mean (overall pain) of these ratings was calculated. Secondary measures included neck disability, pressure pain thresholds (PPTs) at muscular and neural sites, and the global rating of change (GROC). Data were collected at baseline, 4 weeks, and at 3- and 6-months.

RESULTS: A group-by-time interaction was found for pain intensity at rest in neutral position, and for PPTs at ulnar nerve (both sides) and median nerve, anterior scalene, and splenius cervicis (all, left side only; p < 0.05). Post hoc comparisons showed a decrease of overall pain intensity at 6-months in the local DN vs. sham DN groups: estimated ratio ± standard error, 0.55 ± 0.09, p = 0.017. There were no differences between local or distant DN, except for the GROC at discharge.

CONCLUSIONS: Combining DN with HE reduces pain intensity in the medium term compared with HE alone. There were no differences between DN site locations (whether local or distant to the MTrP).

PMID:41319009 | DOI:10.1080/10669817.2025.2591677