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. 2024 Oct 1;31:33–47. doi: 10.1016/j.echu.2024.02.002

Research Trends in Dry Needling for Neck Pain Treatment: A Bibliometric Analysis

Varun Kalia 1,⁎, Priyanka Rajput 1
PMCID: PMC11471195  PMID: 39403608

Abstract

Objective

The objective of this study was to analyze the published literature on the utilization of dry needling in the management of neck pain.

Methods

We performed a bibliometric analysis of publications from January 1, 2002 to December 31, 2022. Using the Scopus database, articles about the utilization of dry needling in neck pain were found. Scopus analyzer was used to obtain results such as “documents by year,” “source,” “country,” and so on. VOS viewer Version 1.6.18 was used to analyze various units such as “co-authorship,” “co-occurrences,” and “citation analysis.”

Results

The search yielded 125 articles. Most articles were published in the years 2022, followed by 2021. A network analysis of various parameters reveals that the topic has a high research potential.

Conclusion

This bibliometric analysis offers an understanding of the literature on dry needling therapy for neck pain. The number of studies in this sector has increased over a decade. There is a gap in research from low- and middle-income countries on use of dry needling in the management of neck pain.

Key Indexing Terms: Neck Pain, Dry Needling, Bibliometrics

Introduction

Neck pain (NP) is a prevalent and debilitating condition that impacts individuals across various age groups and demographics.1 NP prevalence rates varied widely from 45.5% among office employees to 45.8% to 54.7% among health care providers.2,3 Furthermore, the incidence of NP in the overall population varies from 0.4 to 86.8% globally.4 The literature reveals a 59.7% pervasiveness of NP in students of the university, with 51% reporting symptoms as a result of myofascial trigger points within neck muscles.5 As a result, researchers and health care practitioners have continuously sought innovative approaches to enhance NP treatment outcomes. Among these approaches, dry needling has emerged as a promising therapeutic intervention with the potential to alleviate pain, improve function, and enhance the quality of life for individuals with NP.6

Dry needling has garnered substantial attention from researchers, clinicians, and patients alike due to its minimally invasive nature and purported efficacy in targeting myofascial trigger points, improving muscle function, and modulating pain perception. Dry needling refers to the insertion of thin, solid needles into specific anatomical sites, often referred to as trigger points, within muscles, tendons, ligaments, or fascia without the injection of any medication or substance.7

Understanding the trajectory of research trends in dry needling for NP is crucial for several reasons. First, it allows researchers and clinicians to identify the most influential studies, prominent authors, and leading institutions, thereby facilitating the dissemination of evidence-based practices. Second, by mapping out the thematic clusters and areas of active investigation, this analysis can guide future research endeavors and highlight potential gaps in knowledge that warrant further exploration. Additionally, a comprehensive bibliometric analysis can provide a global perspective on the adoption and dissemination of dry needling interventions for NP, helping bridge the gap between research and clinical practice.

A bibliometric analysis would help to shed light on the evolving trends, research hotspots, and key contributors in the field of dry needling for NP treatment. A bibliometric study could offer valuable insights into the growth of research, the distribution of publications, and the collaborative networks that have shaped the landscape of dry needling research in the context of NP. Therefore, the aim of the present study was to provide a comprehensive overview of the research landscape surrounding the application of dry needling for NP.

Methods

Collection of Primary Databases

We used Scopus for the analysis because it is a popular and widely used database for bibliometric analysis8,9 because it provides comprehensive coverage of scientific literature, citation information, allowing researchers to analyze citation patterns, track citation trends, and it assesses the impact of individual publications or authors. On January 21, 2023, the search terms employed in the search yielded a total of 125 publication results.5,9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132 There was no restriction on open access, to the subject area, source title, source type, publication stage, keywords, affiliation, funding sponsor, or country. We limited the search to the English language, the year January 1, 2002 to December 31, 2022, articles, and review documents. Each publication includes details such as author, region, citations, documents, and sources, and the exact data56 were utilized for the analysis. GLOBAL “Guidance list for reporting Bibliometric analysis” was used in this bibliometric analysis presentation.133

Results

Performance Analysis

Along with the “Scopus analysis,” VOS viewer 1.6.18 software134 was used for analysis. It gives a method to perform “Statistical Analysis and network analysis of Databases.” Furthermore, statistical analysis analyzed the “Documents by Source,” “Documents by Year,” “Documents by Subject Area,” “Documents by Type,” “Documents by Country,” “Documents by the Author,” “Documents by Affiliation,” “Documents by Top Funding Agencies.” In addition, network analysis analyzed the documents for “Co-authorship: Authors, organizations, country,” “Co-occurrence: All keywords, Author keywords, Index keywords,” “Citation Analysis: Sources, authors, organizations, country,” “Bibliographic coupling: Documents, Authors.”

Analysis of Keywords

In addition to primary keywords, other keywords were discovered during the search. Table 1 contains a list of the most popular 15 keywords. The keyword with the most publications is “Human,” It has been found that each of these keywords is connected to a person's overall well-being.

Table 1.

Publication Analysis Based on Top 15 Keyword Analysis

Serial Number Keywords Number of Publications
1. Human 114
2. Dry Needling 102
3. Humans 96
4. Trigger Point 95
5. Trigger Points 89
6. Neck Pain 82
7. Adult 80
8. Female 80
9. Myofascial Pain 76
10. Article 70
11. Male 69
12. Controlled Study 67
13. Trapezius Muscle 61
14. Myofascial Pain Syndromes 60
15. Randomized Controlled Trial 60
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Source: http://www.scopus.com (assessed January 21, 2023).

Statistical Analysis

Document Analysis by Sources

A total of 125 articles concerning the utilization of dry needling in the rehabilitation of NP have been published in various journals. The top 10 journals that published articles related to the search topic are listed here in Table 2. Journal of Bodywork and Movement Therapies is the journal that published the maximum number of articles (25 articles) related to the search topic. Figure 1 depicts a pictograph of the various journals, as well as the number of articles published annually.

Table 2.

Analysis of Documents by Sources

Serial Number Journals Number of Published Articles
1. Journal of Bodywork and Movement Therapies 25
2. Journal of Back and Musculoskeletal Rehabilitation 8
3. Acupuncture in Medicine 7
4. American Journal of Physical Medicine & Rehabilitation 7
5. Journal of Orthopaedic & Sports Physical Therapy 6
6. Journal of Manipulative & Physiological Therapeutics 5
7. PM&R 5
8. Archives of Physical Medicine And Rehabilitation 4
9. Journal of Chiropractic Medicine 4
10. Journal of Clinical Medicine 3
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Source: http://www.scopus.com (assessed January 21, 2023).

Fig 1.

Fig 1

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Analysis of documents by sources.

Documents Analysis by Year

Data were gathered from the DBs from the last 2 decades 2002 to 2022 that include articles and review articles. It is observed from the analysis that only 1 article was published in 2002 related to the searched topic and the pace of publication remained low till 2012, then there was a rapid spike in article publication, with 2022 having the most publications, followed by 2021 (Fig 2). Additionally, this shows that there will be plenty of opportunity to work in this field in the years to come.

Fig 2.

Fig 2

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Analysis of documents by year.

Documents by Subject Area

The treatment of NP with dry needling is coming under the scope of medicine and health care and the data analysis also reported the maximum number of article publications done in the field of medicine (51.0%) followed by health professionals (41.7%). Whereas 7.3% of articles are published in other subject areas like Neurosciences, Nursing, Environmental Science, Engineering, Biochemistry, Genetics, Molecular Biology, and Multidisciplinary.

Documents by Type

The analysis shows that journal articles make up the majority of published articles (98), followed by review articles (27).

Analysis of Publications by Country or Territory

Countries were analyzed using the number of articles published in the Scopus DB. It demonstrates that the “United States” has the most articles published “45” between the identified timeline and accompanied by Spain (number 40) & Iran (number 22). Figure 3 depicts the countries in terms of the number of articles published on the searched topic.

Fig 3.

Fig 3

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Analysis of publications by country or territory.

Documents by Author

Authors with multiple publications were considered in this analysis. Dommerholt had the most publications in this area “14,” followed by Hooks, T. “12,” Finnegan, M., and Grieve, R. “8” (Figure in supplementary file).

Documents by Affiliations

The top 15 affiliations were regarded in this analysis. It has been discovered that Universidad Rey Juan Carlos has affiliations in up to 24 published articles, followed by Bethesda Physiocare and Myopain Seminars (14 published articles) (Figure in supplementary file).

Analysis by Funding Sponsors

The “National Institute of Arthritis and Musculoskeletal and Skin Diseases” funds the most research in the “United States.” According to the analysis, the majority of the funding institutes are in the field of health science. Figure 4 depicts the top 15 funding sources for dry-needling research.

Fig 4.

Fig 4

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Analysis of documents by funding sponsor.

Network Analysis and Co-authorship Analysis

Co-authorship in Terms of Authors

This analysis included 3 parameters, that is, authors, organizations, and countries.

This analysis excludes articles with a large number of authors. This estimate is assumed to be 25. An author is considered who have written at least 2 articles.

It was discovered that 70 authors out of 412 have written at least 2 articles. As a whole, co-authorship strength is determined in collaboration with all other authors. Link strengths are achieved using this technique. Dommerholt had the greatest link strength of 36, with 82 citations for 14 different articles. Seventy authors were discovered to be related in regard to co-authorship (Figure in supplementary file).

Co-authorship in Terms of Organizations

Co-authorship in the component of organizations was determined using a minimum of 2 documents in organizations without contemplating citations; 34 organizations fulfill the requirements out of 364 overall organizations.

Co-authorship in Terms of Nation

Regarding the nation, co-authorship was also achieved. There are 27 countries in which these DBs are available. After taking into account the requirement of a minimum of 5 articles in a nation, 7 nations met the requirement. The “United States” was discovered to possess the most citations (950), the strongest link strength (27), and the most published documents (45), which is also the highest among all. Table 3 contains information on 7 countries.

Table 3.

Analysis of Co-authorship in Terms of Nation

Serial Number Nation Document Citations Total Link Strength
1. United States 45 950 27
2. Spain 40 701 13
3. United Kingdom 11 171 11
4. Iran 22 309 5
5. Belgium 5 218 4
6. Taiwan 5 125 4
7. Turkey 10 295 0
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Network Analysis of Co-occurrences

Co-occurrence Analysis in Terms of All Keywords

Different keywords were considered for the co-occurrence analysis. The minimum number of keyword occurrences was considered to be 5. One hundred fifty keywords out of 1091 met the criteria (Fig 5).

Fig 5.

Fig 5

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Co-occurrence analysis in terms of all keywords.

Co-occurrence Analysis in Terms of Author Keywords

The co-occurrence of author keywords has been investigated using a minimum standard of 5 per author. The threshold was met by 15 of the 178 keywords (Fig 6).

Fig 6.

Fig 6

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Co-occurrence network analysis (author keywords).

Co-occurrence in Terms of Index Keywords

Of the 999 index keywords, hardly 138 met the criterion for co-concurrence (Fig 7).

Fig 7.

Fig 7

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Co-occurrence of index keywords.

Network Analysis of Citations

This interpretation was carried out using the following units of analysis: “documents,” “sources,” “authors,” “country,” & “organization.”

Citation Analysis of Documents

A count of 125 documents was used to determine a cutoff of 5 citations per article. As a result, 75 documents met the requirement. Liu et al.108 has the most citations (144), and the link strength is 23 (Fig 8).

Fig 8.

Fig 8

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Network analysis of citations (in terms of documents).

Citation Analysis of Sources

The 5 citations per source limit have been taken into consideration in order to perform citation analysis on the sources. Only 7 of the 50 sources met the criteria. The Journal of Bodywork and Movement Therapies received the most citations (284) (Figure in supplementary file).

Citation Analysis by Authors

The least amount of citations per author regarded here was 3. Among the total of 412 authors, 37 met the criterion. Nourbakhsh has a count of 160 citations (Figure in supplementary file).

Citation Analysis by the Organization

Using a minimum of 3 documents per organization as the threshold, 15 organizations out of 364 met the requirement. The maximum number of citations for Bethesda Physiocare, Bethesda, MD, USA is 82 (Figure in supplementary file).

Citation Analysis by Country

Twenty-seven nations have DBs of dry needling in the treatment of NP. Seven of them fulfilled the citation standards, with a minimum of 5 citations per nation (Fig 9).

Fig 9.

Fig 9

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Citation analysis of the country.

Network Analysis of Bibliographic Coupling

Bibliographic Coupling of Documents

Seventy-five out of 125 articles satisfy the requirement when taking into account a minimum of 5 citations per document. The maximum total link strength and the number of citations for Cerezo-Tellez et al.98 are 408 and 64, respectively (Fig 10).

Fig 10.

Fig 10

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Bibliographic coupling of documents.

Bibliographic Coupling of Authors

Concerning, a least threshold of 3 documents per author there were 37 authors out of 412 authors fulfilled the cutoff requirements (Figure in supplementary file).

Discussion

Bibliometric analysis is a valuable method for evaluating and understanding trends in academic research. The study emphasizes the rising interest and involvement of nations, organizations, and writers in the field of dry needling for the treatment of NP. This shows that there is growing awareness of the potential advantages of dry needling in the management of NP. The collaborative network that has been identified between a few universities and authors points to fruitful partnerships in dry needling management in NP management. This emphasizes how crucial it is for the field to advance through knowledge exchange and teamwork. The chosen keywords—human, dry needling, and neck pain—indicate areas of emphasis on dry needling in the management of NP. This means that researchers are looking into specialized interventions and treatments to deal with the difficulties experienced by people with NP.

The volume of scholarly literature addressing DN for NP has shown a steady increase from 2012 to 2021, suggesting that research into this area has gained significant traction among scholars globally, and provides a solid foundation for subsequent research.

Bibliometric analysis provides information regarding the most popularly used keywords in the highly cited publications and with the help of it; bibliometric analysis can help gauge the impact and influence of these research topics. In addition, researchers and information professionals can use keyword frequency data to refine search strategies for literature reviews and information retrieval, ensuring that relevant publications are captured. Discovering keywords that are less common can highlight knowledge gaps in the literature, prompting researchers to explore new areas of study or contribute to existing gaps.

The Journal of Bodywork and Movement Therapies emerged as the journal with the highest co-citations and centrality, indicating that the research literature published in this journal wields influence and serves as a reference source for future research endeavors. The information regarding the influential journals can potentially attract collaboration opportunities from researchers who are already engaged with those journals.

Studies on DN for NP have been carried out across 27 countries and regions, with the United States and Spain standing out as prominent contributors in this domain. This prominence may be due to their advanced economies and robust health care systems, which foster the development of treatments for NP. Involvement of the 27 countries and prominence of United State and Spain shows that dry needling for NP is a part of broader international efforts.

The analysis of publications by country or territory allows for the identification of countries with strong research output in specific fields. In the present study, the “United States” emerged as the country with the most articles published within the identified timeline, signifying its significant contribution to research in NP.

The examination of documents by author facilitates the quantification of an author's productivity through the analysis of the number of publications ascribed to them. This analytical approach proves valuable in the assessment of the scholarly output manifested by individual researchers within a defined temporal scope. The current investigation revealed that Dommerholt exhibited the highest volume of publications within the examined domain, thereby delineating his specific areas of research interest. This finding implies an opportunity for collaboration with researchers sharing analogous research interests in forthcoming studies. Moreover, institutions and funding agencies can employ bibliometric analysis as a tool for the appraisal of the research output produced by their affiliated authors. The resultant information derived from such analyses serves to guide decisions pertaining to promotions, allocation of funding resources, and strategic planning initiatives.

The analysis of documents by affiliations allows for the systematic evaluation of an institution's research productivity, accomplished by scrutinizing the quantity of publications linked to said institution. These data hold significance for benchmarking exercises and facilitates the comparative assessment of the scholarly output across various research institutions. The current investigation ascertains that Universidad Rey Juan Carlos exhibits affiliations in the highest number of published articles within the investigated research domain. Such discernments provide valuable insights, enabling research institutes to strategically engage in collaborative endeavors with institutions demonstrating optimal research productivity in specific areas of research.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases funds the most research in the United States. This information may help funders identify which research projects and areas have resulted in the most publications and impact, allowing for informed decisions on future funding priorities.

Co-occurrence analysis, as applied to index keywords in bibliometric investigation, entails the identification and examination of the frequency of keywords appearing jointly in scholarly publications. The present study discerned 138 instances of keywords co-occurring with one another. This analytical approach proves instrumental in delineating prevalent research themes by elucidating the keywords that recurrently manifest in conjunction. Such insights contribute to a comprehensive understanding of the primary topics and focal areas within a specific field of research.

The analysis of citation networks involves the examination of relationships between scientific papers, primarily derived from citation patterns. In the current study, it is observed that among 125 documents, 75 have garnered a minimum of 5 citations, with Liu I (2015) emerging as the document with the highest citation count. This information serves to identify citation networks and clusters of interrelated papers, providing researchers with the means to explore cohesive groups of literature, identify influential works, and gain insights into the intellectual structure inherent within a specific field of study.

Strengths and Limitations

In this study, bibliometric analysis was used for the first time to visualize the literature on DN treatment of NP from 2002 to 2022, summarize the research status, and identify the research trend in this field. In addition, we used methods to analyze data, which was suitable for multiangle interpretation of conclusions. However, limitations still exist that need to be addressed. First, only the Scopus database was used in this study. Therefore, it is possible that some papers were missed in our analysis. Furthermore, the exclusion of non-English language publications may result in an incomplete representation of the global research landscape, limiting the generalizability of our findings. Additionally, it is imperative to acknowledge that bibliometric analysis, being primarily reliant on quantitative data, inherently neglects nuanced qualitative aspects of research. As such, critical dimensions such as the novelty of ideas, methodological rigor, and societal impact remain beyond the scope of our evaluation, highlighting the necessity for complementary qualitative assessments to offer a more comprehensive understanding of research contributions.

Future Recommendations

Future research may focus on promoting international collaboration between academic institutions and researchers to foster knowledge sharing, the sharing of best practices, and collaborative research projects. By doing this, the already-existing cooperative network would be strengthened. This may lead to deeper investigation and innovations in the field.

In terms of research output and recognition, future studies should work to close the gap between developed and developing nations. To empower researchers from underdeveloped nations and assure their active engagement in the field, this might encompass measures like capacity-building programs, information transfer, and technology sharing.

Conclusion

This bibliometric analysis offers an understanding of the literature on dry needling therapy for NP. The number of studies in this sector has increased over a decade. There is a gap in research from low- and middle-income countries on use of dry needling in the management of NP.

Acknowledgments

Acknowledgments

The authors thank Mrs. Minni Sharma for reading and correcting the English grammatical part of this manuscript.

Appendix. Supplementary materials

mmc1.docx (725.3KB, docx)

Funding Sources and Conflicts of Interest

No funding sources and conflict of interests were reported for this study.

Contributorship Information

Concept development (provided idea for the research):

V.K.

Design (planned the methods to generate the results):

V.K.

Supervision (oversight, organization and implementation):

V.K.

Data collection/processing (experiments, organization, or reporting data):

V.K., P.R.

Analysis/interpretation (analysis, evaluation, presentation of results):

V.K., P.R.

Literature search (performed the literature search):

P.R.

Writing (responsible for writing a substantive part of the manuscript):

P.R.

Critical review (revised manuscript for intellectual content):

V.K.

Practical Applications.

  • •

    We analyzed the literature on dry needling in the management of neck pain.

  • •

    The search yielded 125 articles.

  • •

    The network analysis of various parameters indicates that there is room for contribution in future research.

Alt-text: Unlabelled box

Footnotes

Supplementary material associated with this article can be found in the online version at doi:10.1016/j.echu.2024.02.002.

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