Neck Pain, Posterior
Conditions
Keywords
Dry Needling
Brief summary
Since neck pain is the fourth highest disabling condition (with an estimated point prevalence of 20%, lifetime prevalence up to 70% and high recurrence rates), dry needling targeting myofascial trigger points in neck muscles has been proposed as an effective treatment for reducing pain and disability in patients with chronic neck pain. A recent meta-analysis reported whether dry needling could be recommended for this population. Low to moderate evidence suggests that dry needling can be effective at the short-term, but its effects on pressure pain sensitivity or cervical range of motion are limited.
Interventions
OTHERDry Needling
Dry needling consists of a skilled intervention which uses a thin filiform needle (as those used in acupuncture) to penetrate the skin and stimulate underlying myofascial trigger points (defined as a hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band which is painful on manual compression and can give rise to characteristic referred pain, referred tenderness, motor dysfunction and autonomic phenomena.) This intervention will be performed targeting the upper trapezius and cervical multifidus muscles
BEHAVIORALTherapeutic Exercise
Patients will include a supervised therapeutic exercise program in their daily life, based on strengthening exercises for neck muscles.
OTHERManual Therapy
Patients will receive a manual compression (30 seconds) over myofascial trigger points located at the upper trapezius muscle, scalene muscles and cervical multifidus muscle.
OTHERSham Dry Needling
For the sham DN intervention, a similar approach will be used, but the skin will be not pierced since the material used will be a telescopic Park's sham device. The guide tube will be pressed against the skin mark and the sham needle will be allowed to drop. The handle will be tapped briskly, but the (blunted) needle tip will not not break the skin.
Sponsors
Universidad Rey Juan Carlos
Camilo Jose Cela University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Intervention model description
Randomized, parallel, controlled and single-blinded clinical trial
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* To be between 18 and 65 years old * To have been experiencing unilateral neck pain for at least 3 months * To have a Neck Disability Index (NDI) score \>8 * To have a Visual Analogue Scale (VAS) score \>3 * To have at least one active MTrP located in the upper trapezius or cervical multifidus muscles
Exclusion criteria
* History of whiplash injury * Previous cervical surgery * Cervical radiculopathy or myelopathy * Diagnosis of fibromyalgia * Additional analgesic treatments during the study (e.g. physiotherapy or drugs) * Psychiatric disorders * Any contraindication to the interventions proposed (e.g. fear of needles or anticoagulants)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analogue Scale | Baseline | A 100mm visual analogue scale will be used. The patient will indicate the level of pain intensity from 0 (no pain) to 10 (the worst pain imaginable) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pittsburg Sleeping Quality Index | Baseline | This is a validated self-reported questionnaire assessing the sleeping quality. Scores range from 0 (best sleep quality) to 21 (worst sleep quality) |
| Hospital Anxiety and Depression Scale | Baseline | This is a validated self-reported questionnaire assessing the level of anxiety and depression in two subscales (HADS-A and HADS-D). Scores for each scale range from 0 to 21 points, where lower scores are associated with lower depressive and anxiety levels. |
| Neck Disability Index | Baseline | This is a validated self-reported questionnaire assessing the neck pain disability. Scores range from 0 (absence of disability) to 100 (worst disability). |
| Tampa Scale for Kinesiophobia | Baseline | The scale consist of 11 items where patients have to choose in a 4-point Likert scale how much they agree with each item, being 1 complete disagreement and 4 complete agreement (total score from 0 to 44), where higher scores indicate greater kinesiophobia. |
Countries
Spain
Outcome results
None listed