• Gracia M Gallego-Sendarrubias, Lennard Voogt, José Luis Arias-Buría, Joel Bialosky, and César Fernández-de-Las-Peñas.
• Department of Physical Therapy, Camilo José Cela University, Madrid, Spain.
• Pain Med. 2022 May 4; 23 (5): 965-976.

ObjectiveDry 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.MethodsWe 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.ResultsIndividuals receiving dry needling exhibited better outcomes immediately and 1 week after the intervention than did those receiving sham needling (all P < 0.01). No general effects of patient expectations, either related to pain recovery or functional improvement, were observed on the clinical outcomes, except for a small association of questionable clinical relevance between positive expectations and localized pressure pain thresholds in the dry needling group.ConclusionThis study did not find a significant effect of predicted patient expectations on the short-term effects of dry needling on pain intensity and pressure pain thresholds in people with mechanical neck pain.© The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine.All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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