J Man Manip Ther. 2025 Oct 28:1-13. doi: 10.1080/10669817.2025.2581047. Online ahead of print.

ABSTRACT

BACKGROUND: Evidence shows that dry needling (DN) influences biochemical substances linked to pain modulation and sleep regulation. Therefore, DN has the potential to be an effective intervention for sleep disturbance (SD) in patients with chronic neck pain (CNP). The aims of this study were to: (1) evaluate the feasibility of combining DN with therapeutic exercise (TE) to improve sleep in individuals with CNP and SD, and (2) explore prelimnary effects of this intervention.

METHODS: Twenty-eight individuals with CNP and SD were randomized to a DN+TE group (n = 14) or TE group (n = 14). The randomized controlled trial (RCT) was deemed feasible if: (1) 4-week attrition rate was < 20%, (2) no significant adverse responses, and (3) ≥ 75% of participants completed follow-up assessments. Outcome measures included sleep duration, sleep quality, pain intensity, and disability level. Sleep duration (via actigraphy) was measured at baseline and weekly for three weeks. Other outcomes-Pittsburgh Sleep Quality Index, Numerical Pain Rating Scale, Neck Disability Index- were assessed at baseline, 4 weeks and 12 weeks post-intervention.

RESULTS: A large-scale RCT was determined to be feasible with an attrition rate of 6.7%, an absence of significant adverse responses, and 93.3% follow-up completion. Both groups demonstrated significant 12-week improvements in pain and disability , but only the DN+TE groupdemonstrated significant gains in sleep quality, greatest after the 4-week intervention.

CONCLUSION: Conducting a large-scale RCT appears feasible, and preliminary findings suggest that DN may improve sleep quality in individuals with CNP and SD. Further studies are required to confirm this finding.

PMID:41147514 | DOI:10.1080/10669817.2025.2581047