110 Participants Needed

Electrical Dry Needling + Physical Therapy for Achilles Tendinopathy

RB
JD
Overseen ByJames Dunning, DPT
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Alabama Physical Therapy & Acupuncture
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 3 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine which treatment is more effective for Achilles tendinopathy, a condition causing pain in the tendon above the heel, especially during running or jumping. It compares two approaches: one using only physical therapy techniques like exercises and stretching, and the other adding electrical dry needling (a technique involving thin needles and mild electrical currents) to the same physical therapy methods. Individuals who have experienced Achilles pain for at least three months without recent physical therapy or other treatments may be suitable candidates. As an unphased trial, this study provides a unique opportunity to explore innovative treatment combinations for Achilles tendinopathy.

Do I have to stop taking my current medications for the trial?

The trial protocol does not specify whether you need to stop taking your current medications.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that dry needling is generally well-tolerated. In studies, patients have responded well to this treatment, with only minor side effects reported. Some individuals might experience temporary pain or bruising at the needle insertion site, but serious complications are rare. Dry needling involves using thin needles to stimulate muscles and relieve pain.

The combination of specific exercises, stretching, and hands-on therapy is also well-known for its safety. Physical therapists commonly use these methods, which usually do not cause major side effects. Most people might experience some soreness, but it is typically mild and temporary.

Overall, both dry needling and the exercise/stretching approach are considered safe for treating conditions like Achilles tendinopathy.12345

Why are researchers excited about this trial?

Researchers are excited about electrical dry needling combined with physical therapy for Achilles tendinopathy because it offers a novel approach to treatment. Unlike standard care options like eccentric exercises and manual therapy, electrical dry needling introduces electrical stimulation directly to the affected tissues, potentially speeding up the healing process. This method could enhance tissue repair and reduce pain more effectively than traditional methods alone. By integrating electrical dry needling with conventional physical therapy, there is hope for improved outcomes and faster recovery times for patients struggling with this common tendon issue.

What evidence suggests that this trial's treatments could be effective for achilles tendinopathy?

In this trial, participants will join one of two treatment arms. One arm will receive Electrical Dry Needling combined with conventional physical therapy, which includes exercises, hands-on therapy, and stretching. Studies have found that this combination reduces pain and improves function in patients, as the needling technique may help stop ongoing damage and promote healing. The other arm will focus on conventional physical therapy alone, involving specific exercises, stretching, and hands-on therapy. These exercises build strength and flexibility, aiding recovery. Both methods have evidence supporting their effectiveness, but adding electrical dry needling might offer extra benefits.24678

Who Is on the Research Team?

JD

James Dunning, DPT

Principal Investigator

American Academy of Manipulative Therapy

Are You a Good Fit for This Trial?

Adults over 18 with Achilles tendinopathy, experiencing pain for at least 3 months, who haven't had related treatments in the last 6 months. Suitable for those without previous Achilles surgery, significant foot instability or conditions that rule out electro-needling like pregnancy.

Inclusion Criteria

My Achilles tendon hurts when it is gently squeezed.
Royal London Test - Tenderness to palpation decreases significantly or disappears with max dorsiflexion
I have been diagnosed with noninsertional tendinopathy.
See 4 more

Exclusion Criteria

The patient is pregnant.
Involvement in litigation or worker's compensation regarding foot pain
I have had arthritis or arthrosis in my ankle or foot.
See 8 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either electrical dry needling with eccentric exercise, stretching, and manual therapy or just eccentric exercise, stretching, and manual therapy

6 weeks
8-10 treatments (1-2 treatments per week)

Follow-up

Participants are monitored for changes in Achilles tendinopathy severity, pain, and foot and ankle ability

3 months
Assessments at baseline, 2 weeks, 6 weeks, and 3 months

What Are the Treatments Tested in This Trial?

Interventions

  • Eccentric Exercise, Stretching and Manual Therapy
  • Electric Dry Needling, Eccentric Exercise, Stretching and Manual Therapy
Trial Overview The trial is testing if adding electric dry needling to conventional physical therapy (eccentric exercise, stretching and manual therapy) provides better outcomes than conventional physical therapy alone for treating Achilles tendinopathy.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Electrical Dry Needling and conventional PTExperimental Treatment1 Intervention
Group II: Conventional PTActive Control1 Intervention

Eccentric Exercise, Stretching and Manual Therapy is already approved in European Union, United States, Canada for the following indications:

🇪🇺
Approved in European Union as Physical Therapy for:
🇺🇸
Approved in United States as Physical Therapy for:
🇨🇦
Approved in Canada as Physical Therapy for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Alabama Physical Therapy & Acupuncture

Lead Sponsor

Trials
15
Recruited
2,200+

Universidad Rey Juan Carlos

Collaborator

Trials
137
Recruited
10,300+

Published Research Related to This Trial

A systematic review of seven studies found low-quality evidence suggesting that a modified version of the Alfredson eccentric loading program is more effective than the standard version for improving function in patients with chronic Achilles tendinopathy.
There is very-low-quality evidence indicating that eccentric loading (ECL) may reduce pain more effectively than concentric loading alone, but it does not show a significant advantage over concentric-eccentric programs in terms of pain or disability improvement.
The efficacy of loading programmes for improving patient-reported outcomes in chronic midportion Achilles tendinopathy: A systematic review.Head, J., Mallows, A., Debenham, J., et al.[2020]
A comprehensive treatment plan combining active and passive warm-up, soft tissue mobilization techniques (Graston and Active Release), eccentric exercise, static stretching, and cryotherapy led to significant pain reduction and functional improvement in a patient with chronic Achilles tendinopathy.
This approach suggests that a multi-faceted conservative treatment strategy can effectively address the symptoms and underlying issues of chronic Achilles tendinopathy, promoting rapid recovery.
Chronic Achilles tendinopathy: a case study of treatment incorporating active and passive tissue warm-up, Graston Technique, ART, eccentric exercise, and cryotherapy.Miners, AL., Bougie, TL.[2022]
A 27-year-old male runner with chronic bilateral Achilles tendinopathy experienced significant pain threshold improvements after a single session of noxious electrical stimulation, indicating its potential effectiveness in altering pain perception.
Following the treatment, the runner was able to progress to more intense workouts, with notable improvements in functional scores (LEFS from 73 to 76 and VISA-A from 64% to 96%), suggesting that noxious electrical stimulation can aid recovery and enhance athletic performance.
IMPROVED PRESSURE PAIN THRESHOLDS AND FUNCTION FOLLOWING NOXIOUS ELECTRICAL STIMULATION ON A RUNNER WITH CHRONIC ACHILLES TENDINOPATHY: A CASE REPORT.Eckenrode, BJ., Stackhouse, SK.[2020]

Citations

Dry Needling as a Treatment Modality for TendinopathyDry needling involves inserting needles into the affected tendon, and it is thought to disrupt the chronic degenerative process and encourage localized ...
Electrical dry needling as an adjunct to exercise, manual ...The inclusion of electrical dry needling into a program of manual therapy, exercise and ultrasound was more effective for improving pain, function and related- ...
Trigger point dry needling, manual therapy and exercise ...Treatment programs for Achilles tendinopathy including eccentric exercise have reported improved pain and function [12] but the healing rate and functional ...
Achilles Pain, Stiffness, and Muscle Power Deficits ...Clinicians may use intramuscular dry needling to treat calf-related muscle pain and stiffness, particularly in those with more acute symptoms ...
Review Article Comparing Dry Needle Therapy and ...This meta-analysis shows that the combination of ESWT with needling therapy is more effective in reducing pain indices in patients with enthesopathy.
Dry Needling: A Clinical Commentary - PMC - PubMed CentralA skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular, and connective ...
Trigger Point Dry Needling, Manual Therapy and Exercise ...Conclusion: A large RCT to investigate the effects of TDN on MTP in Achilles tendinopathy is feasible with modifications. Recommendations: ...
Dry Needling for Tendinopathy 1.16.18Can you Prevent Tendinopathy? • Limited evidence for balance training. • Shock absorbing insoles could have a preventive effect on Achilles.
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