Neck pain is a common condition coming in just behind Low Back Pain in prevalence presenting to primary care physician and Physical Therapy practices. Neck pain is most effectively treated with a combination of manual therapy, including joint mobilization and spinal manipulation, as well as, mobility and strengthening exercises. Consistent with our musculoskeletal diagnoses manual therapy is most appropriate in the short term to relieve pain while strength training exercises help reduce disability and symptom recurrence over the long term.
Recently, dry needling has been utilized more frequently in the medical research for the management of patients with spinal and extremity pain. Researchers and clinicians continue to investigate the most appropriate patients for this intervention, as well as, the most appropriate treatment dosages for this intervention. A recent study documented the impact of dry needling into an established Physical Therapy practice pattern of manual therapy and exercise for patients with neck pain.
Gattie and colleagues published their randomized, controlled trial in the Journal of Orthopedic and Sports Physical Therapy (2020). Authors randomized patients with acute or chronic neck pain to one of two Physical Therapy treatments groups. Each group received spinal mobilizations and manipulations, as well as, strengthening exercises for the neck and shoulder blades. Conversely, one group received 15 minutes of Physical Therapist directed dry needling while the other received a similar amount of sham/placebo dry needling.
Both groups showed significant reductions in pain and disability up to one year after the beginning of the trial, but no differences were found between groups. This indicates dry needling did not increase the overall treatment effect compared to manual therapy and exercise alone. A smaller sub group of patients, likely those with myofascial pain, exists which may be most appropriate for dry needling by Physical Therapists.