Ultrasound-Guided Miniscalpel-Needle Release versus Dry Needling for Chronic Neck Pain: A Randomized Controlled Trial.

Yongjun Zheng,Xiaotong Wu,Dongping Shi,Zisheng Ai,Le Ye,Xiangrui Wang,Kun Tang,Minghong Gu

doi:10.1155/2014/235817

Abstract

Objective. To compare ultrasound-guided miniscalpel-needle (UG-MSN) release versus ultrasound-guided dry needling (UG-DN) for chronic neck pain. Methods. A total of 169 patients with chronic neck pain were randomized to receive either UG-MSN release or UG-DN. Before treatment and at 3 and 6 months posttreatment, pain was measured using a 10-point visual analogue scale (VAS). Neck function was examined using the neck disability index. Health-related quality of life was examined using the physical component score (PCS) and mental component score (MCS) of the SF-36 health status scale. Results. Patients in the UG-MSN release had greater improvement on the VAS (by 2 points at 3 months and 0.9 points at 6 months) versus in the UG-DN arm; (both P < 0.0001). Patients receiving UG-MSN release also showed significantly lower scores on the adjusted neck disability index, as well as significantly lower PCS. No severe complications were observed. Conclusion. UG-MSN release was superior to UG-DN in reducing pain intensity and neck disability in patients with chronic neck pain and was not associated with severe complications. The procedural aspects in the two arms were identical; however, we did not verify the blinding success. As such, the results need to be interpreted with caution.

Highlights

Chronic neck pain is a common and disabling condition [1, 2]
From January 2009 to February 2010, 250 participants were approached, of which 81 were excluded, leaving 169 who were randomized into ultrasound-guided miniscalpel-needle (UG-MSN) or UGDN group (Figure 1)
Of the 169 patients, 14 (8.3%) dropped out, and the dropout rate was similar for the UG-MSN release and ultrasound-guided dry needling (UG-dry needling (DN)) groups (6.8% versus 9.9%, P = 0.5801, χ2 test)

Summary

Introduction

Chronic neck pain is a common and disabling condition [1, 2]. It usually originates in discrete, hyperirritable focal spots (trigger points) in a taut band of skeletal muscle; onset of pain often occurs in conjunction with musculoskeletal disorders [3]. Injecting analgesic medication directly into trigger points could provide short-term relief of the symptoms [3]. Several studies suggested that dry needling (DN; inserting a needle into trigger points) can provide pain relief [4,5,6]. DN of primary trigger points has been shown to inhibit activity at satellite trigger points [7]. A meta-analysis, has concluded that DN does not provide significant therapeutic effect relative to placebo [8]

Methods

Results

Conclusion