Is a Combination of Exercise and Dry Needling Effective for Knee OA?

Pain Med. 2020 Feb 1;21(2):349-363. doi: 10.1093/pm/pnz036.


Objective: To assess the effectiveness of adding dry needling (DN) to an exercise program on pain intensity and disability in patients with knee osteoarthritis.

Design: Double-blind randomized clinical trial with one-year follow-up.

Setting: Older adults in a multicenter study.

Subjects: Sixty-two patients with knee osteoarthritis were randomly allocated into one of two groups: exercise plus DN (exercise + DN; N = 31) or exercise plus sham DN (exercise + sham DN; N = 31).

Methods: Participants received six sessions of either DN or sham DN over the leg muscles related to knee pain from osteoarthritis plus a supervised exercise program. We evaluated between-group differences in terms of the numerical pain rating scale (NPRS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. We used the EuroQol Group 5-Dimension Self-Report Questionnaire, Barthel Index, Timed Up & Go Test, and Global Rating of Change Scale to examine between-group differences for health-related quality of life, functional status evaluation, balance assessment, and clinical progress, respectively.

Results: The groups were not different in terms of pain intensity (0.32 points, 95% confidence interval [CI] = -1.12 to 1.18, P = 0.92) or WOMAC score (0.29 points, 95% CI = -6.16 to 6.74, P = 0.92) at one year. Both groups presented within-group differences at all follow-up periods (F = 28.349, P < 0.0001, ηp2 = 0.32) on secondary outcomes. Nevertheless, 90.3% of the DN group had reduced medication consumption vs only 26.3% in the sham DN group.

Conclusions: The inclusion of DN to an exercise program does not reduce pain or disability in patients with knee osteoarthritis.

Trial registration: NCT02698072.

Keywords: Disability Evaluation; Exercise; Knee; Musculoskeletal Disorders; Osteoarthritis; Pain; Trigger Points.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Combined Modality Therapy / methods*
  • Double-Blind Method
  • Dry Needling / methods*
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Male
  • Osteoarthritis, Knee / therapy*

Associated data