Dry needling versus Manual Therapy in patients with Mechanical Neck Pain: A Randomized Control Trial.

OBJECTIVE: To compare the short- and intermediate-term effects of dry needling to manual therapy on pain, disability, function, and patient-perceived improvement in patients with mechanical neck pain. DESIGN: A single (therapist) blinded randomized controlled trial. METHODS: Seventy-eight patients (mean ± SD age, 50.74 ± 13.81) were randomly assigned to one of the two groups - (1) Dry Needling and Therapeutic Exercises (DN +Exercises) and (2) Manual Therapy and Therapeutic Exercises (MT + Exercises). Both groups received seven treatment sessions over a maximum of 6 weeks. Outcome measures, collected at baseline, 2-weeks, discharge (7th treatment session), and 3 months after discharge were: Neck Disability Index (NDI), Numeric Pain Rating Scale (NPRS), Patient-Specific Functional Scale (PSFS), Global Rating of Change (GROC), Fear Avoidance Belief Questionnaire (FABQ), and Deep Neck Flexor Endurance Test (DNFET). Data were analyzed with mixed model analysis of covariance (ANCOVA), using pretest scores as covariates, and a Mann-Whitney U test for GROC scores. RESULTS: The ANCOVA revealed significant group-by-time interaction for all variables. Significant between-groups differences, favoring MT + Exercises, were observed at all three time points on the NDI (2-week - F1,446 = 172.68, P = < 0.001, ηρ2 = .27; discharge - F1,446 = 254.15, P = < 0.001, ηρ2 = .36; and 3-month F1,446 = 339.40, P = < 0.001, ηρ2 = .43). Results for MT + Exercises group exceeded recommended minimal clinically important difference (MCID) for all variables, at all follow up points. CONCLUSION: MT + Exercises was more effective, both in the short-term and intermediate-term, than DN + Exercises in reducing pain, disability, and improving function in patients with mechanical neck pain.