Accepted for/Published in: JMIR Research Protocols
Date Submitted: Jan 15, 2026
Date Accepted: Jun 19, 2026
Electrical dry needling and therapeutic exercise versus therapeutic exercise in patients with chronic nonspecific neck pain: a study protocol for a randomised controlled trial
ABSTRACT
Background:
Nonspecific chronic mechanical neck pain (NSNP) is one of the most prevalent musculoskeletal disorders worldwide. Its etiology is multifactorial, and it constitutes a leading cause of work absenteeism and a significant socioeconomic burden. Therapeutic exercise, strongly supported by scientific evidence, is considered the cornerstone physiotherapy intervention for its management. In recent years, electrical dry needling has been increasingly applied in musculoskeletal disorders with the aim of modulating pain and improving function.
Objective:
To compare the effectiveness of electrical dry needling combined with therapeutic exercise versus therapeutic exercise alone in patients with nonspecific chronic mechanical neck pain.
Methods:
A randomized, controlled, examiner-blinded clinical trial with two parallel intervention arms will be conducted with 100 participants diagnosed with NSNP, recruited from the outpatient physical therapy department of the University of Almería. Participants will be randomly allocated (1:1) into two groups: the experimental group will receive electrical dry needling combined with therapeutic exercise (n=50), while the control group will undergo a program of therapeutic exercise alone (n=50). Both interventions will consist of six sessions delivered over three weeks. Primary and secondary outcome measures will include cervical disability, pain intensity, sleep quality, health-related quality of life, kinesiophobia, pain catastrophizing, cervical range of motion, pressure pain threshold at myofascial trigger points, and cervical muscle endurance. Assessments will be performed at three time points: baseline, post-intervention, and at three-month follow-up.
Results:
It is hypothesized that the combination of electrical dry needling and therapeutic exercise will yield superior outcomes compared to therapeutic exercise alone in patients with nonspecific chronic mechanical neck pain.
Conclusions:
The findings are expected to inform clinical decision-making, contribute to the optimization of physiotherapeutic strategies, and support the development of more comprehensive and evidence-based clinical practice guidelines. Clinical Trial: ClinicalTrials.gov. Prospectively February 10, 2025.
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