Post-needling soreness depending on the time of dryneedling (before, during and after a manual therapyprotocol) of an active myofascial trigger point in theupper trapezius muscle in patients with mechanical neck pain. A randomized controlled clinical trial.

Research question: could execution time of the dry needling (DN) technique regarding a manual therapy (MT) protocol decrease post-needling soreness in patients with mechanical neck pain and active myofascial trigger point (MTrP) in the upper trapezius muscle? Background information: neck pain is a common pathology and one of the techniques used by the physical-therapist for its treatment is the active MTrP DN of neck muscles. A mild adverse effect of this treatment is the post-needling soreness. Participant characteristics: volunteers patients with mechanical neck pain (of at least 3 months evolution and intensity of 3 cm in the visual analogue scale) and active MTrP in the upper trapezius muscle will be recruited. Key results: the application of DN during MT protocol showed statistically significant differences between groups. Limitations: First, the results were limited by the way of application of the technique. Also age, gender and geographical or cultural differences might be associated with differences in needling tolerance and post-needling soreness intensity. Second, the follow-up was only of one week. Third, we only used the MT and DN techniques to treat these patients, which does not resemble the real clinical practice where a multimodal approach is usually performed. Fourth, we did not collect information about changes in other possible variables related to neck pain such as depression, anxiety, mood or sleep disorders.