Effects of pain neuroscience education and dry needling for the management of patients with chronic myofascial neck pain: a randomized clinical trial

Acupunct Med. 2021 Apr;39(2):91-105. doi: 10.1177/0964528420920300. Epub 2020 May 5.


Objectives: The aim of this study was to observe the medium-term effects on pain, disability, and psychological factors of a combination of myofascial trigger point (MTrP) dry needling (DN) with pain neuroscience education (PNE) versus DN alone versus control care as usual (CUC) in patients with chronic neck pain.

Methods: A total of 60 patients were randomly selected in a Spanish National Health Service Public Hospital and divided into three groups: 6 sessions of DN with 3 sessions of PNE (TrPDN + PNE group, n = 21), 6 sessions of DN alone (TrPDN group, n = 20), or 10 sessions of usual care (CUC group, n = 19). The primary outcome was neck pain intensity, while neck disability, medication intake, and psychological factors were secondary outcomes. These variables were measured at baseline, post-treatment, and at 1 month and 3 months after treatment.

Results: TrPDN + PNE and DN alone were associated with greater reductions in pain intensity and disability compared to CUC (p < 0.01). TrPDN + PNE resulted in greater improvements in kinesiophobia, pain anxiety, and pain-related beliefs than DN alone and CUC (p < 0.01). No differences between groups were observed in medication intake, quality of life, catastrophizing, depression, or fear of pain (p > 0.05).

Discussion: Provision of PNE and DN in the management of chronic neck pain in a Spanish National Health Service Public Hospital was associated with greater improvements in psychological factors than DN therapy only.

Conclusion: DN alone was more effective at reducing chronic non-specific neck pain and disability than CUC at 3-month follow-up. However, the inclusion of PNE combined with DN resulted in greater improvements in kinesiophobia, pain anxiety, and pain-related beliefs.

Trial registration number: NCT03095365 (ClinicalTrials.gov).

Keywords: chronic pain; dry needling; myofascial trigger point; pain neuroscience education; patient education; spine.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Chronic Pain / psychology
  • Chronic Pain / therapy*
  • Dry Needling*
  • Facial Pain / psychology
  • Facial Pain / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neck Pain / psychology
  • Neck Pain / therapy*
  • Neurosciences / education*
  • Psychology
  • Trigger Points
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT03095365