The Importance of the Number of Incisions in the Effectiveness of Dry Needling

Study Overview
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Brief Summary
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The dry needling technique is a procedure increasingly used by health professionals. Dry needling consists of the use of a filiform needle to treat musculoskeletal pain. Currently, the mechanisms by which it is an effective technique are not well understood. One of the aspects not yet evaluated is the best dose in terms of the number of times it is necessary to insert the needle into the patient to achieve the best result. This research work aims to assess which treatment obtains the best results in the management of patients with chronic neck pain.

Detailed Description
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With the objective of demonstrating how the dose used during the application of the dry needling technique is related to the effectiveness of the treatment, we have designed a study where three different doses of the dry needling technique for the treatment of myofascial trigger points will be compared in the upper trapezius muscle in participants with neck pain. Randomly, the participants will be distributed to each of the treatment groups and we will measure how the effectiveness of each of the applied doses determines the result of the application of the dry needling technique in the treatment of neck pain.

Official Title
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Effectiveness of the Dry Needling Technique According to the Number of Incisions in the Treatment of Neck Pain

Conditions
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Neck Pain

Intervention / Treatment
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* Other: Dose of five-incisions dry needling technique
* Other: Dose of ten-incisions dry needling technique
* Other: Dose of fifteen-incisions dry needling technique


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Nonspecific mechanical neck pain for more than 3 months. Neck pain of at least VAS 5/10. Reproduction of pain and symptoms subjects on palpation. Pain on passive stretching of the muscle. Exclusion Criteria: Subjects with previous surgical intervention. Subjects undergoing other intervention (rehabilitation/medication). Positive findings that raise suspicion of cervical radiculopathy: Subjects diagnosed: degenerative arthropathies, inflammatory, systemic conditions (fibromyalgia). Cardiovascular diseases. Whiplash or whiplash. Belenophobia. Dizziness and vertigo. Pregnant. Thyroid disorders.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Dose of five muscle incisions<br>Subjects treated in this group will receive an in-out technique with a dosage of five incisions in the myofascial trigger point of the levator scapulae muscle. | Other: Dose of five-incisions dry needling technique<br>* Once we have assessed the existence of a myofascial trigger point in the levator scapulae muscle, and while the subject is in lateral decubitus on the same side, with a forceps palpation, we apply a rapid in /out dry needling technique (five incisions).<br>|
| Experimental: Dose of ten muscle incisions<br>Subjects treated in this group will receive an in-out technique with a dosage of ten incisions in the myofascial trigger point of the levator scapulae muscle. | Other: Dose of ten-incisions dry needling technique<br>* Once we have assessed the existence of a myofascial trigger point in the levator scapulae muscle, and while the subject is in lateral decubitus on the same side, with a forceps palpation, we apply a rapid in /out dry needling technique (ten incisions).<br>|
| Experimental: Dose of fifteen muscle incisions<br>Subjects treated in this group will receive an in-out technique with a dosage of fifteen incisions in the myofascial trigger point of the levator scapulae muscle. | Other: Dose of fifteen-incisions dry needling technique<br>* Once we have assessed the existence of a myofascial trigger point in the levator scapulae muscle, and while the subject is in lateral decubitus on the same side, with a forceps palpation, we apply a rapid in /out dry needling technique (fifteen incisions).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neck pain | Visual Analog Scale (VAS). VAS is a unidimensional measure of pain intensity, used to record patients' pain progression, or compare pain severity between patients with similar conditions. It is a straight horizontal line of fixed length, usually 100 mm where 0 is no pain and 10 is the worst possible pain. | Change From Baseline in Pain Scores on the Visual Analog Scale at one month. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Disability (Neck disability index) | This questionnaire has been designed to give us information as to how your neck pain has affected your ability to manage in everyday life. It´s value ranges from 0 to 10 to 50 points, where 0 is the absence of disability and 50 is the highest degree of disability. | Change From Baseline in Pain Scores on the Visual Analog Scale at one month. | 
| Pain pressure Threshold | Pain pressure threshold (PPT) is used to measure deep muscular tissue sensitivity. The test determines the amount of pressure over a given area in which a steadily increasing nonpainful pressure stimulus turns into a painful pressure sensation. | Change From Baseline in Pain Scores on the Visual Analog Scale at one month. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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dry needling, myofascial trigger point