Can Patient Expectations Modulate the Short-Term Effects of Dry Needling on Sensitivity Outcomes in Patients with Mechanical Neck Pain? A Randomized Clinical Trial

Abstract Objective Dry needling is commonly used for the management of patients with musculoskeletal pain. However, the effects of patient expectations are uncertain. Our aim was to determine the effect of patient expectations on short-term clinical outcomes after the application of a single session of dry needling in individuals with neck pain. Methods We conducted a randomized, placebo-controlled clinical trial including 50 patients with mechanical neck pain. Participants received a single session of dry needling or sham needling in a blinded design. Predicted patient expectation was categorized as positive, neutral, or negative. Outcomes including neck pain intensity (visual analog scale, 0–100), pressure pain thresholds, and self-perceived improvement (Global Rating of Change, −7 to +7) were assessed at baseline, 1 day after the intervention (immediately after), and 7 days after the intervention (1 week after) by a blinded assessor. Repeated-measures analyses of covariance were conducted to assess the effects of real/sham needling adjusted by patient expectations. Results Individuals receiving dry needling exhibited better outcomes immediately and 1 week after the intervention than did those receiving sham needling (all P