Dry Needling for Knee Pain

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Ohio State University

Disqualifiers: Knee surgery, Pregnancy, Neurological condition, others

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

Approved in 2 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 3

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how dry needling, which uses thin needles to stimulate muscles, affects knee pain and movement in individuals with chronic knee issues. Researchers aim to determine if this treatment can alter how the brain and body perceive and respond to pain, especially in those with knee pain without osteoarthritis. Participants will be grouped based on their fear of movement and presence of knee pain. Individuals who have experienced knee pain for over three months and feel anxious about moving due to pain may be suitable candidates. As an unphased trial, this study provides participants the chance to contribute to innovative research that could enhance future treatments for knee pain.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to consult with the trial coordinators for guidance.

What prior data suggests that dry needling is safe for treating knee pain?

Research shows that dry needling is generally well-tolerated. Studies indicate it can help reduce pain and improve movement in people with knee pain. For example, one study found that patients who underwent dry needling reported less pain and better knee function than before treatment. Another study demonstrated that dry needling can lower pain levels and reduce sensitivity in painful areas.

While these findings are promising, it's important to know that dry needling may cause some mild side effects, such as temporary soreness or bruising at the needle insertion site. These side effects are usually short-lived and not serious. Overall, existing research supports the safety of dry needling as a treatment for knee pain. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about dry needling for knee pain because it offers a new, non-invasive approach to pain relief. Unlike traditional treatments like medication or physical therapy, dry needling involves inserting thin needles into trigger points or tense muscles to relieve pain and improve movement. This technique targets muscle tightness and can potentially provide faster relief and improved function without the side effects often associated with medications. Additionally, dry needling might help those with high fear of movement, addressing both physical and psychological aspects of knee pain.

What evidence suggests that dry needling is effective for knee pain?

Research has shown that dry needling can reduce knee pain and improve movement in people with patellofemoral pain syndrome. Studies have found it may lower pain levels and increase the pressure threshold needed to feel pain, potentially making daily activities less painful. Some individuals notice improvements within 1 to 3 months after treatment. In this trial, participants with bilateral chronic anterior knee pain and varying levels of fear of movement will receive dry needling to assess its effectiveness. Additionally, dry needling might help manage knee pain and related issues over time. Overall, evidence suggests dry needling is a promising option for those with knee pain. ^{1 3 4 5 6}

Who Is on the Research Team?

Matthew S Briggs, DPT, PhD

Principal Investigator

Ohio State University

Are You a Good Fit for This Trial?

This trial is for people aged 18-40 with chronic knee pain, divided into groups based on their fear of movement. One group has high fear (Tampa Scale >37), one has low fear (Tampa Scale <37), and a control group without knee pain. Participants should not have had recent knee surgery, be pregnant, or have neurological issues affecting movement.

Inclusion Criteria

I am 18-40, have had knee pain for 3+ months, low fear of movement, and no knee arthritis.

I am 18-40, have had knee pain for 3+ months, am very afraid of moving in case it causes injury, my knee pain is severe, and I don't have knee arthritis.

Exclusion Criteria

I have an injury to my meniscus, cartilage, or ligaments.

I have a condition that impacts my ability to move.

I have had knee surgery within the last 6 months.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

Baseline Testing

Participants undergo baseline testing including laterality recognition, movement analysis, muscle force production, and ultrasound imaging

45 minutes

1 visit (in-person)

Dry Needling

Dry needling procedure performed on quadriceps muscle

15 minutes

1 visit (in-person)

Post Testing

Participants undergo post testing including laterality recognition, movement analysis, muscle force production, and ultrasound imaging

45 minutes

1 visit (in-person)

Follow-up

Participants are monitored for immediate effects after dry needling

5 minutes

What Are the Treatments Tested in This Trial?

Interventions

• Dry Needling

Trial Overview The study tests if dry needling can improve brain perception related to pain and body part discrimination in those with bilateral knee pain. It involves baseline testing using an app and muscle function analysis, followed by dry needling treatment, then retesting—all within a single two-hour session.

How Is the Trial Designed?

Group I: Bilateral Patellofemoral Pain with Low Fear of Movement Experimental Treatment 1 Intervention

The second group with consist of 20 subjects with bilateral chronic anterior knee pain and low fear of movement between ages of 18 and 40 years old.

Group II: Bilateral Patellofemoral Pain with Fear of Movement Experimental Treatment 1 Intervention

The first group will consist of 20 subjects presenting with bilateral chronic anterior knee pain and high fear of movement with scores on Tampa Kinesiophobia Scale (fear of movement) greater than 37.

Group III: Healthy controls without knee pain Active Control 1 Intervention

The third group will consist of healthy controls without knee pain between 18 and 40 years old.

Dry Needling is already approved in United Kingdom, United States for the following indications:

Approved in United Kingdom as Dry Needling for:

• Knee osteoarthritis pain management
• Muscle strength improvement
• Leg function enhancement

Approved in United States as Dry Needling for:

• Chronic knee pain relief
• Musculoskeletal pain management
• Myofascial pain syndrome treatment

Who Is Running the Clinical Trial?

Ohio State University

Lead Sponsor

Trials

891

Recruited

2,659,000+

Published Research Related to This Trial

Trigger point dry needling shows a moderate effect in reducing pain and improving disability in individuals with patellofemoral pain, based on a meta-analysis of 10 studies involving various knee pain conditions.

While dry needling was effective in the short term, no significant benefits were observed for knee osteoarthritis or post-surgery knee pain, and further high-quality research is needed to assess long-term effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Trigger Point Dry Needling for the Management of Knee Pain Syndromes: A Systematic Review and Meta-Analysis. Rahou-El-Bachiri, Y., Navarro-Santana, MJ., Gómez-Chiguano, GF., et al.[2020]

In a study of 54 patients with patellofemoral pain syndrome, both ischaemic compression and dry needling showed significant improvements in pain, functional status, and sensitivity to mechanical stimulation over a 3-month follow-up period.

There were no significant differences in effectiveness between the two treatment methods, suggesting that both techniques can be considered equally effective for managing symptoms of patellofemoral pain syndrome.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of dry needling and ischaemic compression techniques on pain and function in patients with patellofemoral pain syndrome: a randomised clinical trial. Behrangrad, S., Abbaszadeh-Amirdehi, M., Kordi Yoosefinejad, A., et al.[2021]

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 (DN) significantly improved pain intensity and pressure pain threshold (PPT) in patients with myofascial trigger points in the upper trapezius muscle, showing greater benefits 48 hours after treatment compared to immediate effects.

In contrast, ischemic compression (IC) was more effective immediately after treatment for PPT, but did not show significant improvement in pain intensity over time, highlighting the delayed efficacy of DN.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinical Effectiveness of Dry Needling Immediately After Application on Myofascial Trigger Point in Upper Trapezius Muscle. Ziaeifar, M., Arab, AM., Nourbakhsh, MR.[2022]

In a study involving nine rabbits, dry needling of myofascial trigger points significantly reduced spontaneous electrical activity (SEA) in the treated muscle, indicating its effectiveness in relieving myofascial pain.

The results suggest that eliciting local twitch responses during dry needling is crucial for reducing SEA, highlighting that this response, rather than just the needling itself, plays a key role in the treatment's efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Inhibitory effect of dry needling on the spontaneous electrical activity recorded from myofascial trigger spots of rabbit skeletal muscle. Chen, JT., Chung, KC., Hou, CR., et al.[2019]

In a case series of 14 patients with persistent pain after total knee arthroplasty, a combined treatment of dry needling and therapeutic exercise resulted in a significant reduction in pain intensity and improvements in function and range of motion over 4 weeks.

Patients experienced a decrease in pain scores from an average of 55.6 to 19.3 and improved knee flexion from 82.7° to 93.3°, indicating that this treatment approach may be effective for managing chronic postsurgical pain.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dry Needling Combined With Physical Therapy in Patients With Chronic Postsurgical Pain Following Total Knee Arthroplasty: A Case Series. Núñez-Cortés, R., Cruz-Montecinos, C., Vásquez-Rosel, Á., et al.[2022]

In a study involving 40 female patients with mild to moderate knee osteoarthritis, three sessions of dry needling significantly improved pain, sensitivity, balance, and function compared to a sham treatment.

The results indicate that dry needling is an effective short-term intervention for enhancing functional activity and reducing pain in knee osteoarthritis patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dry needling trigger points around knee and hip joints improves function in patients with mild to moderate knee osteoarthritis. Farazdaghi, M., Kordi Yoosefinejad, A., Abdollahian, N., et al.[2021]

A study involving 40 subjects found that dry needling of myofascial trigger points before total knee arthroplasty significantly reduced pain in the first month post-surgery compared to a placebo group.

The dry needling group also required fewer immediate analgesics after surgery, indicating its effectiveness in managing acute postoperative pain, although the benefits were not sustained at 3 and 6 months follow-up.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of myofascial trigger point dry needling in the prevention of pain after total knee arthroplasty: a randomized, double-blinded, placebo-controlled trial. Mayoral, O., Salvat, I., Martín, MT., et al.[2022]

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/40954658/

The effectiveness of dry needling in patellofemoral pain ... This study approved the effectiveness of dry needling on pain intensity and physical function in patients with patellofemoral PFPS especially in 1-3 months ...

2. jospt.org jospt.org/doi/10.2519/jospt.2017.7096

The Effectiveness of Trigger Point Dry Needling for ... Studies provided evidence that dry needling may decrease pain and increase pressure pain threshold when compared to control/sham or other treatment.

3. clinicaltrials.gov clinicaltrials.gov/study/NCT03966937

Trigger Point Dry Needling In Patient With Patellofemoral ... This study intends to determine the effects of trigger point dry needling in patients with Patellofemoral pain Syndrome. Detailed Description.

4. mdpi.com mdpi.com/2077-0383/9/7/2044

Effects of Trigger Point Dry Needling for the Management ... The results suggest that TrP dry needling may be effective for the management of pain and related disability associated with knee pain (low to moderate ...

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9917679/

Clinical Effectiveness of Dry Needling in Patients with ... A decrease in pain intensity at long-term (13–24 weeks) was found when analyzing DN against other therapies or when comparing DN + other therapies with these ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7354013/

Effects of Trigger Point Dry Needling on Neuromuscular ... From the data collected, the VAS score and Kujala score of the dry needling group were significantly better than before treatment. The trigger ...