Dry Needling for Physical Therapy

Overseen By Eric Parent, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Alberta

Disqualifiers: Not licensed, Cadaver class, Contraindications, Abnormal BMI, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

60 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial protocol does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment Cadaver Anatomy Review in the clinical trial Dry Needling for Physical Therapy?

Research shows that dry needling is a widely accepted treatment used by physical therapists to help release muscle tension and reduce pain, although its effectiveness specifically for neck pain is debated. Understanding anatomy can help minimize risks associated with dry needling. ^{1 2 3 4 5}

Is dry needling generally safe for humans?

Dry needling is generally considered safe, with adverse events (unwanted side effects) occurring in zero to about 10% of cases. Most side effects are mild, but there can be rare severe complications, such as a spinal epidural hematoma (a type of bleeding near the spine), especially if the procedure is not performed carefully. ^{2 3 6 7 8}

How does dry needling treatment differ from other treatments for neck pain?

Dry needling is unique because it involves inserting a thin needle into muscle trigger points to relieve pain and reduce muscle tension, which can help patients return to normal activities faster. Unlike other physical therapy methods, it directly targets specific areas of muscle tightness and pain. ^{2 3 5 9 10}

What is the purpose of this trial?

The goal of this clinical trial is to learn if the addition of cadaver review improves: * the accuracy of physiotherapists who practice dry needling. * the perceived safety of dry needling by physiotherapists. Researchers will compare the effects of an anatomy review using cadaver material to that of an educational intervention not related to anatomy to see if the anatomy review improves the needling accuracy and safety of physiotherapist who practice dry needling as compared to the control intervention of education not related to anatomy. Participants will: * Needle three muscles related to safety and/or accuracy using ultrasound imaging to gather accuracy and safety measurements. * Take an initial knowledge exam capturing their knowledge on needling safety. * Be randomized into a control group or intervention group. * The control group will receive an online educational session not related to anatomy. * The intervention group will receive a cadaver anatomy review class focused on high-risk area. * Re-take a knowledge exam after their course (either cadaver lab or on-line education) to capture any change. * Needle the same three muscles again using ultrasound to capture accuracy and safety measurements. If reviewing anatomy using cadaver materials improve physiotherapists needling accuracy and safety, then this educational intervention could be recommended to be added to dry needling course instruction.

Research Team

Eric Parent, PhD

Principal Investigator

University of Alberta

Eligibility Criteria

This trial is for physiotherapists who practice dry needling. Participants should be willing to undergo educational sessions and demonstrate their needling skills on three specific muscles using ultrasound imaging. There are no specific inclusion or exclusion criteria provided.

Inclusion Criteria

Physiotherapy volunteers must be in good standing with their regulatory College and licensed to practice dry needling

Needling volunteers must be able to provide informed consent

Exclusion Criteria

I do not have conditions that prevent dry needling and my BMI is normal.

I am a licensed physiotherapist, allowed to practice dry needling, and have taken a cadaver review class after graduation.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Participants complete a baseline survey and initial knowledge exam, and initial dry needling accuracy measurements are taken using ultrasound imaging.

1 week

1 visit (in-person)

Intervention

Participants are randomized into control or intervention groups. The control group receives an online educational session not related to anatomy, while the intervention group receives a cadaver anatomy review class.

2 hours

1 visit (in-person or virtual)

Post-Intervention Assessment

Participants retake a knowledge exam and dry needling accuracy measurements are reassessed using ultrasound imaging.

Within 2 weeks post-intervention

1 visit (in-person)

Follow-up

Participants are monitored for changes in knowledge and confidence in needle placement.

2 weeks

Treatment Details

Interventions

• Cadaver Anatomy Review

Trial Overview The study aims to determine if a cadaver anatomy review class can improve the accuracy and perceived safety of dry needling by physiotherapists, compared to a control group receiving unrelated online education.

Participant Groups

Group I: Education: Cadaver anatomy review Experimental Treatment 1 Intervention

A two hour cadaver lab review course focused on high risk areas for dry needling.

Group II: Education: dry needling theory Placebo Group 1 Intervention

A two hour on-line synchronous educational model focused on dry needling theory.

Who Is Running the Clinical Trial?

University of Alberta

Lead Sponsor

Trials

957

Recruited

437,000+

Findings from Research

Dry needling (DN) significantly reduced muscle activity and pain in the upper trapezius muscle of participants with latent trigger points, as shown by lower surface electromyography (sEMG) readings compared to a sham treatment.

Participants receiving DN also experienced a higher pressure pain threshold (PPT) at 72 hours post-treatment, indicating improved pain tolerance compared to those in the sham group.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Changes in electromyographic activity of latent trigger points after a dry needling intervention: a randomised controlled trial. Sánchez-Infante, J., Bravo-Sánchez, A., Esteban-García, P., et al.[2022]

Dry needling is an effective treatment used by physical therapists to relieve pain and muscle tension, but it carries some risks, with adverse effects occurring in about 10% of cases, ranging from mild to severe.

A thorough understanding of anatomy is crucial for safely performing dry needling, as it helps minimize risks such as pneumothorax and infection, and informed consent is essential to communicate these risks to patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

PERTINENT DRY NEEDLING CONSIDERATIONS FOR MINIMIZING ADVERSE EFFECTS - PART ONE. Halle, JS., Halle, RJ.[2022]

In a study involving 39 physiotherapists and 7629 treatments, trigger point dry needling (TrP-DN) was found to have a high incidence of mild adverse events (AEs), with 1463 reported cases, but no significant AEs occurred, indicating a very low risk of serious complications (≤ 0.04%).

Common mild AEs included bruising (7.55%) and bleeding (4.65%), but the overall safety profile suggests that TrP-DN is a safe treatment option for myofascial pain when performed by trained physiotherapists.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse events following trigger point dry needling: a prospective survey of chartered physiotherapists. Brady, S., McEvoy, J., Dommerholt, J., et al.[2022]

Dry needling is generally safe and well tolerated for treating myofascial pain, but there is a risk of severe complications, such as an acute spinal epidural hematoma, as highlighted in this case report.

Healthcare providers should exercise caution when performing dry needling near the spine, and any sudden neuropathic pain following the procedure should be evaluated immediately with advanced imaging to ensure spinal cord integrity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acute Spinal Epidural Hematoma as a Complication of Dry Needling: A Case Report. Berrigan, WA., Whitehair, CL., Zorowitz, RD.[2020]

References

1. United States pubmed.ncbi.nlm.nih.gov

Dry Needling Adds No Benefit to the Treatment of Neck Pain: A Sham-Controlled Randomized Clinical Trial With 1-Year Follow-up. [2021]

2. United States pubmed.ncbi.nlm.nih.gov

PERTINENT DRY NEEDLING CONSIDERATIONS FOR MINIMIZING ADVERSE EFFECTS - PART TWO. [2022]

3. Spain pubmed.ncbi.nlm.nih.gov

[Efficacy of dry needling in neck pain compared with other physiotherapy techniques: A systematic review]. [2020]

4. England pubmed.ncbi.nlm.nih.gov

Changes in electromyographic activity of latent trigger points after a dry needling intervention: a randomised controlled trial. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

PERTINENT DRY NEEDLING CONSIDERATIONS FOR MINIMIZING ADVERSE EFFECTS - PART ONE. [2022]

6. England pubmed.ncbi.nlm.nih.gov

Adverse events following trigger point dry needling: a prospective survey of chartered physiotherapists. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Acute Spinal Epidural Hematoma as a Complication of Dry Needling: A Case Report. [2020]

8. Switzerland pubmed.ncbi.nlm.nih.gov

Clinical Effectiveness of Dry Needling in Patients with Musculoskeletal Pain-An Umbrella Review. [2023]

9. United States pubmed.ncbi.nlm.nih.gov

Cadaveric validation of dry needle placement in the lateral pterygoid muscle. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

The use of dry needling for a subject with acute onset of neck pain: a case report. [2020]