Effectiveness of Dry Needling versus Trigger Point Compression Release among Patients with Neck Pain - RCT

Abstract

Background: Neck pain is a disorder that has lifetime and point prevalence almost as high as low back pain. It also leads to substantial disability and economic burden on society. Physical therapists use several interventions with this population such as ischemic compression which is a standard treatment used for the treatment of trigger point release in routine physical therapy practice. Dry needling is comparatively a newer treatment intervention in practice now for the relieve of pain causing trigger points not specifically in case of neck pain but in other condition such as Fibromyalgia, Myofascial Pain Syndrome as well.

Objective: To determine the effectiveness of Trigger point Dry Needling compared with ischemic compression release in the patients having neck pain due to myofascial trigger points and to create awareness about better treatment intervention for trigger point release among medical community.

Methodology: A Randomized Clinical Trail of 16 weeks duration is conducted in Physical Therapy Department of Holy Family Hospital Rawalpindi comprised of patients with neck pain associated with trigger points. A sample of 30 patients was taken fulfilling the inclusion & exclusion criteria. Initially the patients were recruited using non-probability convenient sampling, later the allocation between the groups was done randomly using sealed envelope method. Participants were randomly divided in dry needling group (N = 15) and trigger point compression release group (N = 15). The data was collected at 1st week and final (4th) week. Improvement was assessed through Visual Analog Scale(VAS) and Northwick Park Neck Pain Questionnaire(NPQ).

Results: Findings from independent t- test used for comparison between the two groups showed significant p-value at the final week which is less than 0.05 for both VAS and NPQ (P=0.038; 0.018 respectively). Within the group comparison using repeated measure ANOVA showed significant improvement in the experimental group for both the variables after week 2, with the significant value of wilk’s lambda ^ (^=0.001) which is less than 0.05.

Conclusion: Dry needling is more effective than ischemic compression for the trigger point release.

Key Words: Dry needling, Ischemic compression, Neck pain