Dry Needling and Patients Treatment Expectations

University of Alcala

Status: Enrolling

Conditions: Neck Pain; Dry Needling; Motivation

Treatments: Other: Negative expectation AND dry needling in the upper trapezius fibers, at the most painful point; Other: Neutral expectation AND dry needling in the upper trapezius fibers, at the most painful point; Other: Positive expectation AND dry needling in the upper trapezius fibers, at the most painful point

Study type: Interventional

Funder types: Other

Identifiers

NCT04636879

CEI20/009

Details and patient eligibility

About

Objectives The aim of this study is to compare the effects of inducing positive expectations against negative or neutral induced expectations on the activation of the Autonomic Nervous System and the analgesic response, after a dry needling technique in upper trapezius fibers in patients with unspecific neck pain.

Summary Theoretical framework: Dry needling has proven its efficacy for the treatment of myofascial trigger points. Moreover, it has proven its effects over the Central Nervous System and the Autonomic Nervous System (ANS). Despite that previous studies have researched the role of patient's expectations and their relationship with the results of treatment, there is insufficient information concerning the effects of inducing expectations and the activation of the ANS during the application of widely used therapies, such as dry needling.

Full description

The aim of this study will be to research the effects of induced expectations combined with a dry needling technique on the activation of the ANS and on the results of the treatment.

Hypothesis: The induction of a positive expectation shall cause a greater analgesic response associated with a response in the ANS compared to the induction of neutral or negative expectations.

Methods: Patients with neck pain will participated in this randomized clinical trial, which will be randomly assigned into 3 groups in order to receive positive, neutral or negative expectations concerning the treatment, by means of an individual informative talk. All subjects will received treatment using dry needling in the upper trapezius fibers. The main variables measured will be the following: Analogic Visual Scale, Pressure Pain Threshold using a mechanical Force Gage (before and after) and the activation of the ANS measuring the skin conductance, skin temperature, heart rate and breathing rate (monitored for 5 minutes before the intervention, during and 20 minutes afterwards).

Enrollment: 45 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Neck pain.
• Hiperalgesic point in Upper trapezius muscle.

Exclusion criteria

• Pain Irradiation toward upper limb
• Psychological disorders
• Whiplash.
• Neuropathic symptoms
• Cervical and / or Shoulder Spine Surgery

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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45 participants in 3 patient groups

• Group 1. Positive expectation

Experimental group

Description:

"Dry needling is a very effective tool used in the treatment of nonspecific neck pain, which we hope will reduce your neck pain."

Treatment:

Other: Positive expectation AND dry needling in the upper trapezius fibers, at the most painful point

• Group 2. Neutral Expectation

Active Comparator group

Description:

"Dry needling is an indicated tool used in the treatment of nonspecific neck pain, but its efficacy is unknown".

Treatment:

Other: Neutral expectation AND dry needling in the upper trapezius fibers, at the most painful point

• Group 3. Negative Expectation

Active Comparator group

Description:

"Dry needling is not a very effective treatment tool for nonspecific neck pain, so we expect your neck pain to increase a bit."

Treatment:

Other: Negative expectation AND dry needling in the upper trapezius fibers, at the most painful point