Dry Needling vs Electrical Dry Needling for Myofascial Neck Pain

Comparative Effects of Dry Needling Versus Electrical Dry Needling on Myofascial Trigger Point-Induced Neck Pain, Psychological Distress, and Kinesiophobia

Neck pain caused by myofascial trigger points (MTrPs) is common and is associated with pain, psychological distress, and kinesiophobia (fear of movement). This randomized clinical trial compared Dry Needling (DN) and Electrical Dry Needling (EDN), each delivered once weekly for six weeks, in adults with neck pain due to MTrPs. The study measured changes in pain intensity, psychological distress (depression, anxiety, stress), and kinesiophobia before and after treatment, to determine whether adding electrical stimulation to dry needling provides additional benefit over dry needling alone.

This randomized clinical trial was conducted at Madinah Teaching Hospital, Health 360, and Holistic Medical Care in Faisalabad. A total of 75 participants were screened; 34 met the inclusion criteria (adults aged 18-60 years with neck pain of at least 3 weeks' duration, at least one active myofascial trigger point in the upper trapezius, levator scapulae, sternocleidomastoid, splenius capitis, or scalenes, and pain intensity of at least 4 on the Numeric Pain Rating Scale) and were randomized into two equal groups using simple random sampling. Group A (n=17) received Dry Needling and Group B (n=17) received Electrical Dry Needling, one session per week for six weeks. Dry Needling used the Hong fast-in/fast-out technique to elicit local twitch responses followed by ischemic compression. Electrical Dry Needling involved needle insertion into the trigger point/taut band followed by low-frequency (2 Hz) continuous biphasic electrical current applied for 30 minutes. Outcomes were assessed at baseline and after 6 weeks using the Numeric Pain Rating Scale (NPRS), the Depression Anxiety and Stress Scale (DASS-21), and the Tampa Scale for Kinesiophobia (TSK-11). One participant dropped out of each group, leaving 32 participants (16 per group) in the final analysis. Data were analyzed using SPSS version 20 with parametric (paired and independent samples t-tests) and nonparametric (Wilcoxon Signed-Rank, Mann-Whitney U) tests as appropriate.

Inclusion Criteria:

• Adults aged 18-60 years of either gender.
• Neck pain duration ≥ 3 weeks.
• Presence of at least one active myofascial trigger point in the upper trapezius, levator scapulae, SCM, splenius capitis, or scalenes, confirmed using Travell and Simons' criteria.
• Pain intensity ≥ 4 on NPRS (0-10) at baseline.
• Ability to understand and complete questionnaires.
• Willingness to participate and provide written informed consent.

Exclusion Criteria:

• History of cervical spine trauma, fracture, or surgery.
• Diagnosis of neurological deficits.
• Systemic diseases affecting muscles or joints.
• Use of anticoagulant therapy or bleeding disorders.
• Pregnancy or lactation.
• Active infection or skin lesions in the cervical region.
• Previous dry needling or electrical dry needling treatment in the past 6 months.
• Allergy to needles or local anesthetics if used.