The Importance of the Number of Incisions in the Effectiveness of Dry Needling

Effectiveness of the Dry Needling Technique According to the Number of Incisions in the Treatment of Neck Pain

The dry needling technique is a procedure increasingly used by health professionals.

Dry needling consists of the use of a filiform needle to treat musculoskeletal pain. Currently, the mechanisms by which it is an effective technique are not well understood. One of the aspects not yet evaluated is the best dose in terms of the number of times it is necessary to insert the needle into the patient to achieve the best result.

This research work aims to assess which treatment obtains the best results in the management of patients with chronic neck pain.

Study Overview

• Status: Active, not recruiting
• Conditions: Neck Pain
• Intervention / Treatment: Other: Dose of five-incisions dry needling technique; Other: Dose of ten-incisions dry needling technique; Other: Dose of fifteen-incisions dry needling technique

Detailed Description

With the objective of demonstrating how the dose used during the application of the dry needling technique is related to the effectiveness of the treatment, we have designed a study where three different doses of the dry needling technique for the treatment of myofascial trigger points will be compared in the upper trapezius muscle in participants with neck pain.

Randomly, the participants will be distributed to each of the treatment groups and we will measure how the effectiveness of each of the applied doses determines the result of the application of the dry needling technique in the treatment of neck pain.

• Study Type: Interventional
• Enrollment (Actual): 90
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Spain
  • Madrid
    • Alcalá de Henares, Madrid, Spain, 28805
      • Physiotherapy and Pain Institute
    • Alcalá de Henares, Madrid, Spain, 28805
      • Centro Investigación Fisioterapia y Dolor

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Nonspecific mechanical neck pain for more than 3 months.
• Neck pain of at least VAS 5/10.
• Reproduction of pain and symptoms subjects on palpation.
• Pain on passive stretching of the muscle.

Exclusion Criteria:

• Subjects with previous surgical intervention.
• Subjects undergoing other intervention (rehabilitation/medication).
• Positive findings that raise suspicion of cervical radiculopathy:
• Subjects diagnosed: degenerative arthropathies, inflammatory, systemic conditions (fibromyalgia).
• Cardiovascular diseases.
• Whiplash or whiplash.
• Belenophobia.
• Dizziness and vertigo.
• Pregnant.
• Thyroid disorders.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Triple

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Dose of five muscle incisions; Subjects treated in this group will receive an in-out technique with a dosage of five incisions in the myofascial trigger point of the levator scapulae muscle.	Other: Dose of five-incisions dry needling technique; Once we have assessed the existence of a myofascial trigger point in the levator scapulae muscle, and while the subject is in lateral decubitus on the same side, with a forceps palpation, we apply a rapid in /out dry needling technique (five incisions).
Experimental: Dose of ten muscle incisions; Subjects treated in this group will receive an in-out technique with a dosage of ten incisions in the myofascial trigger point of the levator scapulae muscle.	Other: Dose of ten-incisions dry needling technique; Once we have assessed the existence of a myofascial trigger point in the levator scapulae muscle, and while the subject is in lateral decubitus on the same side, with a forceps palpation, we apply a rapid in /out dry needling technique (ten incisions).
Experimental: Dose of fifteen muscle incisions; Subjects treated in this group will receive an in-out technique with a dosage of fifteen incisions in the myofascial trigger point of the levator scapulae muscle.	Other: Dose of fifteen-incisions dry needling technique; Once we have assessed the existence of a myofascial trigger point in the levator scapulae muscle, and while the subject is in lateral decubitus on the same side, with a forceps palpation, we apply a rapid in /out dry needling technique (fifteen incisions).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Neck pain	Visual Analog Scale (VAS). VAS is a unidimensional measure of pain intensity, used to record patients' pain progression, or compare pain severity between patients with similar conditions. It is a straight horizontal line of fixed length, usually 100 mm where 0 is no pain and 10 is the worst possible pain.	Change From Baseline in Pain Scores on the Visual Analog Scale at one month.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Disability (Neck disability index)	This questionnaire has been designed to give us information as to how your neck pain has affected your ability to manage in everyday life. It´s value ranges from 0 to 10 to 50 points, where 0 is the absence of disability and 50 is the highest degree of disability.	Change From Baseline in Pain Scores on the Visual Analog Scale at one month.
Pain catastrophizing	Pain Catastrophizing Scale (PCS). The PCS is a 13-item instrumen that task participants to reflect on past painful experiences, and to indicate the degree to which they experienced each of 13 thoughts or feelings when experiencing pain, on 5-point scales with the end points (0) not at all and (4) all the time. The PCS total scores range from 0 - 52. 0 is the best result and 52 is the worst result.	Change From Baseline in Pain Scores on the Visual Analog Scale at one month.
kinesiophobia	The Tampa Scale of Kinesiophobia (TSK) describe patient circumstances characterised by an "excessive, irrational, and debilitating fear of physical movement and activity resulting from a feeling of vulnerability to painful injury or reinjury. The TSK is a 17 item assessment checklist.The 17 item TSK total scores range from 17 to 68 where the lowest 17 means no or negligible kinesiophobia, and the higher scores indicate an increasing degree of kinesiophobia.	Change From Baseline in Pain Scores on the Visual Analog Scale at one month.
The Global Rating of Change (GRoC)	It's a scale that assesses whether the patient condition has gotten worse, better, or stayed	Change From Baseline in Pain Scores on the Visual Analog Scale at one month.

Collaborators and Investigators

• Sponsor: University of Alcala
• Investigators: Study Director: Daniel Pecos-Martin, PhD, Alcala University

Study record dates

Study Major Dates

• Study Start (Actual): December 4, 2023
• Primary Completion (Actual): January 20, 2026
• Study Completion (Estimated): June 20, 2026

Study Registration Dates

• First Submitted: November 20, 2023
• First Submitted That Met QC Criteria: November 20, 2023
• First Posted (Actual): November 29, 2023

Study Record Updates

• Last Update Posted (Actual): May 1, 2026
• Last Update Submitted That Met QC Criteria: April 27, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: dry needling; myofascial trigger point
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Neck Pain
• Other Study ID Numbers: CEIM/2022/1/008

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No