Study Evaluating the Benefit of Dry Needling for Patients With Neck Pain

The Effectiveness of Dry Needling for Patients With Neck Pain: A Randomized Clinical Trial

The purpose of this study is to determine whether individuals with neck pain will respond favorably to a program of manual therapy, directed at the cervical and thoracic spine (including thrust manipulation), and exercise, in combination with dry needling, as compared to manual therapy, directed to the cervical and thoracic spine (including thrust manipulation), and an exercise program alone.

Inclusion Criteria:

1. Age between 18-60 years old
2. Primary complaint of neck pain
3. Restricted cervical extension/and or cervical rotation ROM
4. Neck Disability Index > 20 points

Exclusion Criteria:

1. Red flags noted in the patient's Neck Medical Screening Questionnaire (i.e. tumor, fracture, metabolic diseases, RA, osteoporosis, prolonged history of steroid use, symptoms of vertebrobasilary 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 headaches

9. Insufficient English language skills to complete all questionnaires

10. Inability to comply with treatment and follow-up schedule