Gallego-Sendarrubias GM, Voogt L, Arias-Buria JL, et al. Can Patient Expectations Modulate the Short-Term Effects of Dry Needling on Sensitivity Outcomes in Patients with Mechanical Neck Pain? A Randomised Clinical Trial. Pain Med. 2021 Apr 8. pii: 6217368. doi: 10.1093/pm/pnab134. (Original study)

OBJECTIVE: Dry needling is commonly used for the management of musculoskeletal pain patients. However, the effects of patient expectations are uncertain. Our aim was to determine the effect of patient expectations on short-term clinical outcomes after the application of a single session of dry needling in individuals with neck pain.

METHODS: We conducted a randomized, placebo controlled, clinical trial including fifty patients with mechanical neck pain. Participants received a single session of dry needling or sham needling in a blinded design. Predicted patient expectation was categorized as positive, neutral, or negative. Outcomes including neck pain intensity (visual analogue scale, 0-100), pressure pain thresholds (PPTs) and self-perceived improvement (Global Rating of Change [GROC], -7 to + 7) were assessed at baseline, one day (immediately post), and 7 days (one week) after the intervention by a blinded assessor. Repeated measures ANCOVAs were conducted to assess the effects of real/sham needling adjusted by patient expectations.

RESULTS: Individuals receiving dry needling exhibited better outcomes than those receiving sham needling immediately and one-week after (all, P < 0.01). No general effects of patient expectations, either related to pain recovery or function improvement, were observed on the clinical outcomes, except for a small association of questionable clinical relevance between positive expectations and localized PPTs in the dry needling group.

CONCLUSION: This study did not find a significant effect of predicted patient expectations on the short-term effects of dry needling on pain intensity and PPTs in people with mechanical neck pain.

Discipline Area Score
Physician 5 / 7
Rehab Clinician (OT/PT) 4 / 7
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Comments from MORE raters

Physician rater

It is interesting that this paper made it clear that one traditional pain management method, ie, dry needling, has a positive pain management effect and is not affected by the patients' attitude.

Rehab Clinician (OT/PT) rater

The results of this study are based on ONE application/session of dry-needling. This does not reflect clinical practice, so the results are not clinically relevant. Also, due to the small sample size, we cannot extrapolate the results to a broader population.
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