Dry Needling for Knee Pain

Overseen by Matthew S Briggs, DPT, PhD

Age: 18 - 65

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: Ohio State University

Disqualifiers: Bilateral patellofemoral pain, Pregnancy, Neurological condition, others

No Placebo Group

Approved in 2 Jurisdictions

Trial Summary

What is the purpose of this trial?

This trial is testing dry needling for knee pain relief in patients with patellofemoral pain syndrome. The treatment involves inserting small needles into muscles to help them relax and reduce pain. The study aims to see if this method improves pain, muscle strength, and leg function.

Will I have to stop taking my current medications?

The trial protocol does not specify whether you need to stop taking your current medications. However, you cannot be actively receiving treatment for knee pain outside of the study while enrolled.

What data supports the effectiveness of the treatment Dry Needling for Knee Pain?

Research shows that dry needling can reduce pain in the first month after knee surgery, and it is more effective than a placebo. Additionally, dry needling has been found to help with pain and function in knee-related conditions like patellofemoral pain syndrome. ^{1 2 3 4 5}

How does dry needling treatment for knee pain differ from other treatments?

Dry needling is unique because it involves inserting thin needles into specific muscle areas called trigger points to relieve pain and improve function, unlike other treatments that may rely on medication or physical therapy alone. It can be particularly effective for those who have not responded to conventional treatments, as it targets the muscle's electrical activity to reduce pain. ^{1 2 6 7 8}

Research Team

Matthew S Briggs, DPT, PhD

Principal Investigator

Ohio State University

Eligibility Criteria

This trial is for individuals aged 18-40 with knee pain around the patella when doing activities like stairs, squatting, or running for at least 3 months. They must be referred for physical therapy and not currently receiving other treatments for knee pain. People can't join if they have bilateral knee syndrome, recent surgery or PT treatment, pregnancy, neurological conditions affecting movement, needle phobias, bleeding disorders, cancer diagnosis or systemic illnesses.

Inclusion Criteria

I am between 18 and 40 years old.

I have been referred for physical therapy.

I have had knee pain near my kneecap when moving or squatting for over 3 months.

Exclusion Criteria

I have had dry needling treatments before.

I have been experiencing pain for less than 3 months.

Actively receiving treatment for knee pain outside of the current study protocol while enrolled in the study

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive dry needling or sham dry needling to the gluteal and/or quadriceps muscles over 2 consecutive weeks in addition to standard physical therapy

2 weeks

2 sessions

Follow-up

Participants are monitored for changes in pain, muscle performance, and function after treatment

1 week

Post testing at week 3

Treatment Details

Interventions

• Dry Needling (Other)

Trial Overview The study examines dry needling's effectiveness in managing knee pain and improving muscle strength and leg function. Participants will receive either actual dry needling or a sham (fake) procedure alongside their regular physical therapy to compare outcomes.

Participant Groups

Group I: Quad Dry Needling Experimental Treatment 1 Intervention

Receives dry needling to their quadriceps muscles in addition to standard physical therapy treatment.

Group II: Glute Dry Needling Experimental Treatment 1 Intervention

Receives dry needling to their gluteal muscles in addition to standard physical therapy treatment.

Group III: Control Active Control 1 Intervention

Receives only standard physical therapy treatment.

Group IV: Glute Sham Dry Needling Placebo Group 1 Intervention

Receives sham dry needling to their gluteal muscles in addition to standard physical therapy treatment.

Group V: Quad Sham Dry Needling Placebo Group 1 Intervention

Receives sham dry needling to their quadriceps muscles in addition to standard physical therapy treatment.

Who Is Running the Clinical Trial?

Ohio State University

Lead Sponsor

Trials

891

Recruited

2,659,000+

Dr. John J. Warner

Ohio State University

Chief Executive Officer since 2023

MD, MBA

Dr. Peter Mohler

Ohio State University

Chief Medical Officer since 2023

PhD in Molecular Biology

Findings from Research

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]

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]

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 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 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]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

Effects of Trigger Point Dry Needling for the Management of Knee Pain Syndromes: A Systematic Review and Meta-Analysis. [2020]

2. England 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. [2021]

3. England pubmed.ncbi.nlm.nih.gov

Changes in electromyographic activity of latent trigger points after a dry needling intervention: a randomised controlled trial. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Clinical Effectiveness of Dry Needling Immediately After Application on Myofascial Trigger Point in Upper Trapezius Muscle. [2022]

5. United States 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. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Dry Needling Combined With Physical Therapy in Patients With Chronic Postsurgical Pain Following Total Knee Arthroplasty: A Case Series. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Inhibitory effect of dry needling on the spontaneous electrical activity recorded from myofascial trigger spots of rabbit skeletal muscle. [2019]

8. United States pubmed.ncbi.nlm.nih.gov

Dry needling trigger points around knee and hip joints improves function in patients with mild to moderate knee osteoarthritis. [2021]