Dry Needling for Patients With Neck Pain

NCT ID: NCT02731014

Last Updated: 2019-12-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

77 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-09-30

Study Completion Date

2019-09-30

Brief Summary

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The aim of this trial will be to examine the short and long term effectiveness of dry needling on pain, disability, and patient perceived improvements in patients with neck pain attending physical therapy. The investigators hypothesize that patients who receive dry needling, manual therapy, and exercise will achieve greater reductions in pain and disability in the short (4 weeks) and long term (6 and 12 months) compared to those who receive sham dry needling, manual therapy, and exercise.

Detailed Description

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Background: Neck pain is a costly and common problem. Current treatments are not adequately effective for a large proportion of patients who continue to experience recurrent pain. Therefore, new treatment strategies should be investigated in an attempt to reduce the disability and high costs associated with neck pain.

Dry needling is a technique in which a fine needle is used to penetrate the skin, subcutaneous tissues, and muscle with the intent to mechanically disrupt tissue without the use of an anesthetic. Dry needling is emerging as a treatment modality that is widely used clinically to address a variety of musculoskeletal conditions. Recent studies of dry needling in mechanical neck pain have shown decreased pain, increased pain pressure threshold, improved range of motion, and decreased disability in the short term. The majority of these studies examined dry needling using methods atypical to clinical practice (dry needling as a sole treatment, or fewer visits than is common practice). None included long-term follow up. A clinical trial with realistic treatment time frames and methods consistent with clinical practice is needed to examine the effectiveness of dry needling on reducing pain and enhancing function in patients presenting with mechanical neck pain.

Purpose: The aim of this trial will be to examine the short and long term effectiveness of dry needling on pain, disability, and patient perceived improvements in patients with neck pain.

Design: The investigators will conduct a randomized single blind placebo controlled trial in accordance with the CONSORT guidelines. All patients with mechanical neck pain referred to physical therapy will be screened for eligibility criteria. Participants will be randomized to receive 1) dry needling, manual therapy, and exercise or 2) sham dry needling, manual therapy and exercise. Participants will receive 7 treatments over a maximum of 4 weeks.

Methods: The primary outcome will be disability as measured by the Neck Disability Index. Pain and patient perceived improvement will also be recorded. Outcome measures will be assessed at 4 weeks, 6 months, and 12-months by an assessor who is blind to the group allocation of the participants to determine the short and long-term treatment effects.

Data Analysis: The investigators will examine the primary aim with a 2-way repeated-measures analysis of variance (ANOVA) with treatment group as the between subject variable and time as the within-subjects variable. The hypothesis of interest will be the 2-way group by time interaction.

Significance: The successful completion of this trial will provide evidence to demonstrate whether dry needling is effective for the management of mechanical neck pain when used in a combined treatment approach as is commonly practiced clinically.

Conditions

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Neck Pain

Keywords

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Dry Needling

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Dry Needling Group

Dry Needling, Manual Therapy, and Exercise.

Group Type EXPERIMENTAL

Dry Needling

Intervention Type OTHER

Dry Needling targeting the posterior musculature of the cervical and thoracic spine.

Manual Therapy

Intervention Type OTHER

Manual Therapy(mobilization/ manipulation) to address joint mobility of the cervical and thoracic spine.

Exercise

Intervention Type OTHER

Exercise designed to improve performance of both the deep neck flexor musculature as well as the scapular musculature. The exercise portion will also include a stretching program targeting the cervicothoracic muscles which have been placed in a shortened position as a result of poor postures.

Sham Dry Needling Group

Sham Dry Needling, Manual Therapy, and Exercise.

Group Type SHAM_COMPARATOR

Sham Dry Needling

Intervention Type OTHER

Sham Dry Needling performed with Park sham acupuncture needles (Acuprime, UK) will be used to perform sham dry-needling. The device consists of 2 plastic tubes that slide into one another and cause a pricking sensation when pushed against the skin.

Manual Therapy

Intervention Type OTHER

Manual Therapy(mobilization/ manipulation) to address joint mobility of the cervical and thoracic spine.

Exercise

Intervention Type OTHER

Exercise designed to improve performance of both the deep neck flexor musculature as well as the scapular musculature. The exercise portion will also include a stretching program targeting the cervicothoracic muscles which have been placed in a shortened position as a result of poor postures.

Interventions

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Dry Needling

Dry Needling targeting the posterior musculature of the cervical and thoracic spine.

Intervention Type OTHER

Sham Dry Needling

Sham Dry Needling performed with Park sham acupuncture needles (Acuprime, UK) will be used to perform sham dry-needling. The device consists of 2 plastic tubes that slide into one another and cause a pricking sensation when pushed against the skin.

Intervention Type OTHER

Manual Therapy

Manual Therapy(mobilization/ manipulation) to address joint mobility of the cervical and thoracic spine.

Intervention Type OTHER

Exercise

Exercise designed to improve performance of both the deep neck flexor musculature as well as the scapular musculature. The exercise portion will also include a stretching program targeting the cervicothoracic muscles which have been placed in a shortened position as a result of poor postures.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Age between \>18 years old
2. Primary complaint of neck pain
3. Neck Disability Index \> 10 points=20%

Exclusion Criteria

1. Red flags noted in the patient's Neck Medical Screening Questionnaire (i.e. tumor, fracture, metabolic diseases, Rheumatoid Arthritis, osteoporosis, prolonged history of steroid use, symptoms of vertebrobasilar insufficiency, pregnancy, cervical spinal stenosis, bilateral upper extremity symptoms etc.
2. Use of blood thinners
3. History of whiplash injury within the past six weeks
4. Evidence of central nervous system involvement, to include hyperreflexia, sensory disturbances in the hand, intrinsic muscle wasting of the hands, unsteadiness during walking, nystagmus, loss of visual acuity, impaired sensation of the face, altered taste, the presence of pathological reflexes (i.e. positive Hoffman's and/or Babinski reflexes), etc.
5. Two or more positive neurologic signs consistent with nerve root compression, including any two of the following:

* Muscle weakness involving a major muscle group of the upper extremity
* Diminished upper extremity muscle stretch reflex (biceps brachii, brachioradialis, or triceps)
* Diminished or absent sensation to pinprick in any upper extremity dermatome
6. Prior surgery to the neck or thoracic spine
7. Chiropractic, Physical Therapy, or Acupuncture treatment for their neck pain in the last 12-months
8. Workers compensation or pending legal action regarding their neck pain
9. Insufficient English language skills to complete all questionnaires
10. Inability to comply with treatment and follow-up schedule
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Newcastle University

OTHER

Sponsor Role collaborator

Concord Hospital

OTHER

Sponsor Role collaborator

Franklin Pierce University

OTHER

Sponsor Role lead

Responsible Party

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Joshua Cleland, DPT, OCS

Professor of Physical Therapy

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Franciscan, ST.Francis Health

Indianapolis, Indiana, United States

Site Status

Concord Hospital Rehabilitation Services

Concord, New Hampshire, United States

Site Status

Countries

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United States

References

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Gattie ER, Cleland JA, Snodgrass SJ. Dry Needling for Patients With Neck Pain: Protocol of a Randomized Clinical Trial. JMIR Res Protoc. 2017 Nov 22;6(11):e227. doi: 10.2196/resprot.7980.

Reference Type DERIVED
PMID: 29167092 (View on PubMed)

Other Identifiers

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HIC 15-6

Identifier Type: -

Identifier Source: org_study_id