Dry Needling for Mechanical Neck Pain

January 16, 2026 updated by: Deraya University

Effect of Dry Needling in the Treatment of Patients With Mechanical Neck Pain

Mechanical neck pain is one of the most common musculoskeletal disorders among adults. It is characterized by pain and stiffness in the cervical region, often related to poor posture, repetitive movements, or prolonged sitting. The condition can lead to functional limitations and decreased quality of life.

This randomized controlled clinical trial aims to evaluate the effectiveness of dry needling therapy on pain intensity, cervical range of motion, and functional ability in patients with mechanical neck pain. Forty participants aged 25 - 65 years will be randomly assigned to two groups. Group A will receive dry needling combined with neck exercises, while Group B will receive transcutaneous electrical nerve stimulation (TENS), ultrasound, and the same neck exercise program. Both groups will undergo treatment three times per week for four weeks.

Primary outcomes include changes in the Neck Disability Index (NDI), pressure pain threshold (PPT) measured by algometer, and cervical range of motion (CROM). The study will determine whether dry needling provides superior clinical improvement compared with conventional electrotherapy and exercise.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Mechanical neck pain (MNP) affects a large proportion of adults between 25 and 65 years of age. It is commonly associated with sustained poor posture, repetitive movement, or prolonged sitting, leading to muscular tightness and joint stiffness in the cervical region. Patients typically present with pain, limited cervical mobility, and decreased ability to perform daily activities.

Dry needling is a minimally invasive technique that involves inserting fine monofilament needles into myofascial trigger points to reduce muscle tension, improve circulation, and alleviate pain. It is increasingly used in physiotherapy practice as a targeted intervention for musculoskeletal pain conditions. By releasing taut muscle bands, dry needling is believed to normalize muscle tone and restore normal movement patterns.

The current randomized controlled trial is designed to assess the effectiveness of dry needling combined with therapeutic exercise compared with conventional physiotherapy including TENS, ultrasound, and the same exercise regimen. Forty participants with mechanical neck pain will be randomly allocated into two equal groups (n = 20 per group).

Group A (Experimental): Dry needling will be applied to the upper trapezius and deltoid muscles under aseptic technique. Each needle will be inserted 5 - 10 mm deep and retained for approximately 30 seconds. This intervention will be combined with a neck exercise program consisting of chin-in exercises (3 sets × 10 repetitions, 5-second hold) and a muscle-energy technique for the upper trapezius (3 repetitions per side, 5 - 10 second holds).

Group B (Active Comparator): Participants will receive TENS at 80 - 100 Hz frequency, 100 µs pulse duration for 20 minutes, and pulsed ultrasound at 1 MHz, 1.0 - 1.5 W/cm² for 5 minutes. The same chin-in and muscle-energy exercise protocol will be applied.

Both groups will receive three sessions per week for four weeks. Assessments will include:

Pain and disability using the Neck Disability Index (NDI).

Pressure pain threshold (PPT) using a handheld algometer.

Cervical range of motion (CROM) using a cervical range-of-motion device.

Outcomes will be recorded at baseline and after four weeks of treatment. It is hypothesized that dry needling will produce greater reductions in pain and disability and larger improvements in cervical motion compared with conventional therapy.

Study Type

Interventional

Enrollment (Actual)

40

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Egypt
    • Menia Governorate
      • Minya, Menia Governorate, Egypt
        • faculty of physical therapy, Deraya University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Medically stable individuals who provide written informed consent to participate in the study.
  • Age between 25 and 65 years.
  • Both male and female participants.
  • Patients diagnosed with mechanical neck pain lasting more than three months.
  • Presence of myofascial trigger points in the upper trapezius or cervical muscles confirmed by palpation.
  • Ability to follow treatment instructions and attend all scheduled sessions.

Exclusion Criteria:

  • History of neck surgery or cervical spine fracture.
  • Previous dry needling or invasive therapy for neck pain in the past six months.
  • History of neurological disorders (e.g., cervical radiculopathy, myelopathy).
  • Current acute infection, skin disease, or open wound in the neck or shoulder region.
  • Use of anticoagulant medication or any bleeding disorder.
  • Pregnancy or suspected pregnancy.
  • Any systemic illness (e.g., diabetes mellitus, rheumatoid arthritis) that may affect healing or pain perception.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Dry Needling with Exercise

Participants in this group will receive dry needling to the upper trapezius and deltoid muscles under aseptic conditions. Needles will be inserted 5-10 mm deep and held for approximately 30 seconds, then discarded.

This intervention will be combined with a neck exercise program including chin-in exercises (3 sets × 10 repetitions, 5-second holds) and a muscle energy technique (3 repetitions per side, holding 5-10 seconds).

Sessions: three per week for four weeks.
Other: Dry Needling with Exercise

Manual therapy procedure using sterile, single-use needles inserted into the upper trapezius and deltoid muscles for approximately 30 seconds to reduce trigger point activity. Combined with neck exercises (chin-in and muscle-energy technique).

Administered three times per week for four weeks.
Active Comparator: Conventional Physiotherapy with Exercise

Participants in this group will receive conventional physiotherapy including transcutaneous electrical nerve stimulation (TENS) at 80-100 Hz, 100 µs pulse duration for 20 minutes, and pulsed ultrasound at 1 MHz, 1.0-1.5 W/cm² for 5 minutes.

The same exercise program will be applied (chin-in and muscle-energy technique).

Sessions: three per week for four weeks.
Other: Conventional Physiotherapy with Exercise

Standard physiotherapy treatment consisting of TENS (80-100 Hz, 100 µs, 20 min) and ultrasound (1 MHz, 1.0-1.5 W/cm², 5 min) combined with neck exercises (chin-in and muscle-energy technique).

Administered three times per week for four weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Neck Disability Index (NDI)
Time Frame: Baseline and after 4 weeks of treatment
The Neck Disability Index (NDI) is a 10-item self-reported questionnaire used to assess how mechanical neck pain affects daily activities. Each item is scored from 0 to 5, and total scores are converted to a percentage, with higher values indicating greater disability. It is a valid and reliable tool for monitoring functional improvement after physiotherapy interventions.
Baseline and after 4 weeks of treatment
Change in Pressure Pain Threshold (PPT)
Time Frame: Baseline and after 4 weeks of treatment
Pressure Pain Threshold (PPT) will be measured using a digital algometer. It represents the minimum pressure that elicits pain and provides an objective assessment of muscle tenderness and trigger point sensitivity. Higher values indicate reduced pain sensitivity. Measurements will be taken over the upper trapezius muscle in kg/cm².
Baseline and after 4 weeks of treatment
Change in Cervical Range of Motion (CROM)
Time Frame: Baseline and after 4 weeks of treatment
Cervical Range of Motion (CROM) will be assessed using a CROM device that quantifies cervical flexion, extension, lateral flexion, and rotation. Measurements will be taken in degrees. The device provides objective and reproducible data on cervical spine mobility and is used to evaluate the effect of treatment on movement limitations.
Baseline and after 4 weeks of treatment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Deraya University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 5, 2025

Primary Completion (Actual)

December 1, 2025

Study Completion (Actual)

December 15, 2025

Study Registration Dates

First Submitted

January 16, 2026

First Submitted That Met QC Criteria

January 16, 2026

First Posted (Actual)

January 26, 2026

Study Record Updates

Last Update Posted (Actual)

January 26, 2026

Last Update Submitted That Met QC Criteria

January 16, 2026

Last Verified

May 1, 2018

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Dry Needling

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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