Tender points in the trapezius and levator scapulae muscles are common in patients with chronic mechanical neck pain. These tender points are referred to as “Trigger points” which continues to be a controversial entity. Nonetheless, there is not much controversy that some people have tender spots in some of their neck muscles.

Depending on the bias of the health care provider these tender points may be treated by soft-tissue work using various manual therapies and/or dry needling.


This RCT compared the effect of soft-tissue manual therapy (MT) with and without dry needling (DN) on one hundred patients with chronic mechanical neck pain. Those in the treatment group received two 5-minutes of DN prior to their 1-hour soft-tissue MT session. Those in the control or sham group received the same treatment, except that the needling involved a blunt tip needle that did not even penetrate the skin, in other words, placebo needling.

Immediately after each session and after 4 weeks, both groups showed improvements in various outcome measures, however compared to the placebo needling group, those who received the two 5-minute sessions of real DN had significantly greater improvements in their pain, function and neck mobility.

I fully realize that overall needling gets a bad rap as many studies show that it is no more effective than placebo; however this 2020 RCT supports that two 5 minute sessions of dry needling was BETTER than placebo.

Reference: Gallego-Sendarrubias et al Efficacy of dry needling as an adjunct to manual therapy for patients with chronic mechanical neck pain: a randomised clinical trial Acupunct Med . 2020 Aug;38(4):244-254.

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