Dry Needling for Mechanical Neck Pain

Mechanical neck pain (MNP) affects a large proportion of adults between 25 and 65 years of age. It is commonly associated with sustained poor posture, repetitive movement, or prolonged sitting, leading to muscular tightness and joint stiffness in the cervical region. Patients typically present with pain, limited cervical mobility, and decreased ability to perform daily activities. Dry needling is a minimally invasive technique that involves inserting fine monofilament needles into myofascial trigger points to reduce muscle tension, improve circulation, and alleviate pain. It is increasingly used in physiotherapy practice as a targeted intervention for musculoskeletal pain conditions. By releasing taut muscle bands, dry needling is believed to normalize muscle tone and restore normal movement patterns. The current randomized controlled trial is designed to assess the effectiveness of dry needling combined with therapeutic exercise compared with conventional physiotherapy including TENS, ultrasound, and the same exercise regimen. Forty participants with mechanical neck pain will be randomly allocated into two equal groups (n = 20 per group). Group A (Experimental): Dry needling will be applied to the upper trapezius and deltoid muscles under aseptic technique. Each needle will be inserted 5 - 10 mm deep and retained for approximately 30 seconds. This intervention will be combined with a neck exercise program consisting of chin-in exercises (3 sets × 10 repetitions, 5-second hold) and a muscle-energy technique for the upper trapezius (3 repetitions per side, 5 - 10 second holds). Group B (Active Comparator): Participants will receive TENS at 80 - 100 Hz frequency, 100 µs pulse duration for 20 minutes, and pulsed ultrasound at 1 MHz, 1.0 - 1.5 W/cm² for 5 minutes. The same chin-in and muscle-energy exercise protocol will be applied. Both groups will receive three sessions per week for four weeks. Assessments will include: Pain and disability using the Neck Disability Index (NDI). Pressure pain threshold (PPT) using a handheld algometer. Cervical range of motion (CROM) using a cervical range-of-motion device. Outcomes will be recorded at baseline and after four weeks of treatment. It is hypothesized that dry needling will produce greater reductions in pain and disability and larger improvements in cervical motion compared with conventional therapy.