Dry needling frequency and its effect on pain and disability in acute cervical myofascial pain: a multicenter study - 07/06/26
, Adrian Kużdżał c, Filipe Manuel Clemente d, e, f, Ana Filipa Silva e, Robert Trybulski a, gHighlights |
• | Thrice-weekly dry needling reduces muscle stiffness and tone more effectively. |
• | Both dosing schedules lessen neck pain compared with sham treatment. |
• | Disability improves over time, but not more with higher frequency. |
• | Frequent sessions increase mild, short-lasting adverse events. |
• | Higher dosing may benefit tissue outcomes without added pain relief. |
Abstract |
Background |
Optimal dry needling frequency for chronic mechanical neck pain remains uncertain, warranting dose–response testing.
Objectives |
To investigate whether dry needling delivered once (DN1x) vs 3 (DN3x) times per week provides differential effects compared with sham DN on muscle stiffness and tone, pressure pain threshold (PPT), cervical range of motion, pain intensity, disability, and safety in chronic mechanical neck pain.
Methods |
A multicenter, randomized, assessor- and participant-blinded trial allocated 96 participants to DN1x, DN3x, sham DN once weekly (sDN1x), or sham dry needling 3 times weekly (sDN3x) for 6 weeks. Primary outcomes were pain intensity and disability. Secondary outcomes included upper trapezius and levator scapulae pressure pain thresholds (PPT), stiffness and tone, and range of motion. Mixed-model ANOVAs tested group × time effects.
Results |
Pain intensity decreased in both DN1x and DN3x (median pain intensity 6–2) compared with sham (no change), but without between-dose differences. Disability improved significantly over time in all groups ( P < 0.001, partial η² = 0.554) with no group differences (all P > 0.05). At 6 weeks, DN3x produced greater reductions in muscle stiffness and tone than sham (group × time, P < 0.01, partial η² up to 0.20). For PPT, a significant group × time effect was found ( P = 0.008, partial η² = 0.116). DN3x increased trapezius PPT by +7.19 kg/cm² from baseline ( P < 0.001), significantly higher than sDN1x ( P < 0.001) and sDN3x ( P < 0.001). Cervical extension showed a group × time interaction ( P = 0.004), favoring DN3x over sham at week 6. No serious adverse events occurred; 133 mild events (eg, soreness, bruising) were reported, all in DN groups and more frequent with DN3x.
Conclusions |
In acute cervical myofascial pain, DN1x and DN3x did not show superiority over sham for the primary outcomes of pain intensity and disability over 6 weeks. Higher-frequency DN yielded greater improvements in tissue-level outcomes and PPT, and modest improvements in cervical extension, but with milder adverse events. The added value of higher frequency appears outcome-specific.
Trial Registration |
ISRCTN16484644.
Le texte complet de cet article est disponible en PDF.Keywords : Musculoskeletal disorders, Trigger point therapy, Muscle properties, Neck disability index, Sham intervention
List of abbreviations : ANOVA, BMI, C1, C4, C7, CGRP, CI, CONSORT, CROM, DN, DN1x, DN3x, IQR, LAT, LS, LTR, MTrP, MTrPs, NDI, PPT
Plan
Vol 69 - N° 5
Article 102112- juin 2026 Retour au numéro
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