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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
34
Stainless-steel acupuncture needles inserted via guide tubes using the Hong technique (rapid insertion/withdrawal in multiple directions) to elicit up to 5 local twitch responses at the active myofascial trigger point, followed by ischemic (Travell and Simons) compression until pain decreased, repeated over several cycles for a total of 2 minutes. One session weekly for 6 weeks.
Needle inserted (after cleaning with sterile alcohol) into the diagnosed active or latent myofascial trigger point/taut band, manipulated bidirectionally to elicit pain/tingling/pressure/heaviness/warmth, then connected to a low-frequency (2 Hz) continuous biphasic electrical current at a mild-to-moderate intensity, left in place for 30 minutes. One session weekly for 6 weeks.
The University of Faisalabad
Faisalābad, Punjab Province, Pakistan
Pain Intensity
Measured using the Numeric Pain Rating Scale (NPRS), an 11-point scale where 0 = "no pain" and 10 = "worst pain imaginable".
Time frame: Baseline (pre-treatment) and Week 6 (post-treatment)
Psychological Distress
Measured using the Depression, Anxiety and Stress Scale (DASS-21), covering depression, anxiety, and stress subscales.
Time frame: Baseline (pre-treatment) and Week 6 (post-treatment)
Kinesiophobia
Measured using the Tampa Scale for Kinesiophobia (TSK-11), an 11-item scale assessing fear of movement/re-injury.
Time frame: Baseline (pre-treatment) and Week 6 (post-treatment)
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