DryNeedlinginPhysicalTherapyTreatmentofChronicNeckPain:SystematicReview

Chronic neck pain (CNP) affects over 30% of people worldwide and becomes a persistent condition in half of cases, leading to significant disability and socioeconomic costs. Traditional treatments like manual therapy and exercise have limited effectiveness, prompting researchers to explore invasive physiotherapy techniques. Dry needling is a minimally invasive technique that uses acupuncture needles to target myofascial trigger points without injecting substances, aiming to restore normal tissue function and reduce pain through mechanical stimulation.

The researchers conducted a systematic review following PRISMA guidelines, searching five major databases for randomized controlled trials comparing dry needling to other treatments for chronic neck pain. They used specific search terms ("chronic neck pain" AND "dry needling") and included only studies of adult patients with non-traumatic chronic neck pain lasting more than three months. Two independent reviewers screened articles, applied inclusion criteria, and assessed study quality using the PEDro scale. They excluded studies focused on traditional Chinese medicine acupuncture, non-physiotherapy techniques, or studies not conducted in humans.

Eight randomized controlled trials involving 807 participants with chronic neck pain met inclusion criteria. Most studies achieved high methodological quality scores (5-8 out of 10 on PEDro scale). The most commonly measured outcomes were pain intensity (using VAS or NPRS scales), disability (using Neck Disability Index), and pressure pain threshold. Treatment protocols varied from single sessions to 6-7 sessions over 2-4 weeks, primarily targeting upper trapezius and levator scapulae muscles.

Seven studies showed positive short-term effects of dry needling on pain reduction, with benefits lasting 3-6 months in follow-up assessments. However, one high-quality study with one-year follow-up found no significant differences between dry needling and sham treatment. Most studies combined dry needling with stretching, manual therapy, or therapeutic exercises.

This review provides encouraging evidence that dry needling can be an effective treatment option for chronic neck pain, particularly in the short to medium term. The technique appears most beneficial when targeting upper trapezius and levator scapulae trigger points, following established protocols, and combined with other physiotherapy interventions like stretching and manual therapy. However, the evidence for long-term benefits beyond six months is limited. For clinicians, this suggests dry needling can be recommended as part of a multimodal approach for chronic neck pain patients, with realistic expectations about duration of benefits.

The optimal treatment appears to be 4-6 sessions over 2-4 weeks, though more research is needed to establish standardized protocols and determine which patients respond best to this intervention.