Table 3.
Main results and raw data of the included studies.
| Study | Outcome/Group | Baseline mean (SD) | Immediate, less than one week after a single session | Short-term, 1–12 weeks, mean (SD) | Midterm, 12–24 weeks, mean (SD) | Long-term, >24 weeks, mean (SD) | |||
|---|---|---|---|---|---|---|---|---|---|
| Dry needling combined with other interventions vs. other intervention alone | |||||||||
| Tough et al., 2010 [26] | Pain (VAS, 0–10) | 4.9 (1.6) | — | 1.71 (2.0) (6 wk) | — | — | |||
| G1 | 5.0 (1.6) | — | 3.2 (2.8) (6 wk) | — | — | ||||
| G2 | 18.6 (8.7) | — | 8.4 (7.8) (6 wk) | — | — | ||||
| Disability (NDI) | |||||||||
| G1 | 20.5 (7.6) | — | 11.9 (8.8) (6 wk) | — | — | ||||
| G2 | — | — | — | ||||||
|
| |||||||||
| Sterling et al., 2015 [27] | Pain (NPRS, (0–10) | ||||||||
| G1 | 5.6 (2.2) | — | 3.2 (2.0) (6 wk) | 3.2 (2.1) (12 wk) | 2.8 (2.4) (54 wk) | ||||
| G2 | 5.4 (2.0) | — | 3.2 (2.3) (6 wk) | 3.5 (2.3) (12 wk) | 3.3 (2.6) (54 wk) | ||||
| Disability (NDI, %) | |||||||||
| G1 | 42.9 (15.2) | — | 32.2 (16.8) (6 wk) | 30.8 (17.1) (12 wk) | 27.3 (16.5) (54 wk) | ||||
| G2 | 42.9 (13.1) | — | 32.7 (16.8) (6 wk) | 32.1 (16.0) (12 wk) | 34.1 (18.4) (54 wk) | ||||
| Cervical flexion (°) | |||||||||
| G1 | 39.7 (16.1) | — | 39.2 (15.8) (6 wk) | 41.7 (18.7) (12 wk) | 42.5 (16.5) (54 wk) | ||||
| G2 | 39.7 (14.9) | — | 41.2 (19.1) (6 wk) | 39.6 (16.5) (12 wk) | 44.3 (17.0) (54 wk) | ||||
| Cervical extension (°) | |||||||||
| G1 | 33.3 (13.2) | — | 39.9 (13.3) (6 wk) | 39.8 (13.6) (12 wk) | 42.3 (14.1) (54 wk) | ||||
| G2 | 36.3 (16.3) | — | 41.8 (15.8) (6 wk) | 40.8 (16.1) (12 wk) | 46.1 (17.6) (54 wk) | ||||
|
| |||||||||
| Sterling et al., 2015 [27] | Right cervical rotation (°) | ||||||||
| G1 | 45.8 (17.6) | — | 51.6 (18.4) (6 wk) | 52.0 (19.5) (12 wk) | 54.0 (19.2) (54 wk) | ||||
| G2 | 42.0 (22.5) | — | 52.5 (17.4) (6 wk) | 48.8 (17.9) (12 wk) | 55.7 (17.7) (54 wk) | ||||
| Left cervical rotation (°) | |||||||||
| G1 | 43.6 (16.3) | — | 49.5 (17.2) (6 wk) | 49.7 (20.3) (12 wk) | 51.3 (18.4) (54 wk) | ||||
| G2 | 46.3 (15.1) | — | 48.8 (15.8) (6 wk) | 46.4 (16.3) (12 wk) | 51.4 (18.6) (54 wk) | ||||
| Cervical rotation (mean calculated) | |||||||||
| G1 | 44.7 (16.95) | — | 50.55 (17.8) (6 wk) | 50.85 (19.9) (12 wk) | 52.65 (18.8) (54 wk) | ||||
| G2 | 44.15 (18.8) | — | 50.65 (16.6) (6 wk) | 47.6 (17.1) (12 wk) | 53.55 (18.15) (54 wk) | ||||
| PPT (kPa) | |||||||||
| G1 | 153.8 (100.4) | — | 191.8 (79.1) (6 wk) | 213.2 (137.0) (12 wk) | 193.9 (112.1) (54 wk) | ||||
| G2 | 174.7 (108.5) | — | 199.4 (122.1) (6 wk) | 181.1 (106.5) (12 wk) | 200.2 (100.6) (54 wk) | ||||
| Pain catastrophizing (PCS) | |||||||||
| G1 | 18.0 (11.3) | — | 11.0 (9.5) (6 wk) | 11.8 (11.0) (12 wk) | 8.0 (10.8) (54 wk) | ||||
| G2 | 20.4 (13.8) | — | 17.6 (13.6) (6 wk) | 16.7 (12.3) (12 wk) | 12.6 (11.8) (54 wk) | ||||
|
| |||||||||
| Cerezo Tellez et al., 2016 [29] | Pain (VAS, 0–10) | ||||||||
| G1 | 5.1 (1.6) | — | 0.29 (0.88) (2 wk) | — | 1.02 (2) (24 wk) | ||||
| G2 | 5.1 (1.4) | — | 3.53 (1.6) (2 wk) | — | 3.5 (2.16) (24 wk) | ||||
| PPT (kPa) right trapezius | |||||||||
| G1 | 205.93 (68.64) | — | 480.51 (172.64) (2 wk) | — | 429.52 (212.08) (24 wk) | ||||
| G2 | 196.13 (58.83) | — | 292.23 (86.32) (2 wk) | — | 304.98 (125.52) (24 wk) | ||||
| PPT (kPa) left trapezius | |||||||||
| G1 | 205.93 (78.45) | — | 462.86 (160) (2 wk) | — | 413.82 (224) (24 wk) | ||||
| G2 | 205.93 (78.45) | — | 297.13 (80) (2 wk) | — | 306.93 (88) (24 wk) | ||||
| PPT (kPa) mean calculated | |||||||||
| G1 | 205.93 (73.54) | — | 471.68 (166.32) (2 wk) | — | 421.67 (218.04) | ||||
| G2 | 201.03 (68.64) | — | 294.68 (83.16) (2 wk) | — | 305.95 (106.76) | ||||
|
| |||||||||
| Cerezo Tellez et al., 2016 [29] | Cervical rotation (°) | ||||||||
| G1 | 53.9 (11.25) | — | 61.95 (7.04) (2 wk) | — | 62.8 (7.12) (24 wk) | ||||
| G2 | 53.3 (9.05) | — | 55.31 (5.84) (2 wk) | — | 55.29 (4.76) (24 wk) | ||||
| Cervical lateral-flexion (°) | |||||||||
| G1 | 31.55 (8.1) | — | 38.09 (6.56) (2 wk) | — | 38.3 (6.76) (24 wk) | ||||
| G2 | 29.95 (6.75) | — | 31.96 (4.16) (2 wk) | — | 32.41 (5.72) (24 wk) | ||||
| Cervical flexion-extension (°) | |||||||||
| G1 | 49.9 (9.45) | — | 58.45 (6.56) (2 wk) | — | 59.55 (7.2) (24 wk) | ||||
| G2 | 51 (8.3) | — | 52.89 (5.84) (2 wk) | — | 53.49 (9.08) (24 wk) | ||||
| Disability (NDI) | |||||||||
| G1 | 30.5 (16) | — | 13.2 (16.48) (2 wk) | — | 12 (18.16) (24 wk) | ||||
| G2 | 31 (12) | — | 24.53 (14.16) (2 wk) | — | 22.57 (14.72) (24 wk) | ||||
|
| |||||||||
| Cerezo-Tellez et al., 2016 [30] | Pain (VAS, 0–10)+ | ||||||||
| G1 | 5.8 (0.79) | — | 0.10 (0.23) (2 wk) | — | — | ||||
| G2 | 5.0 (1.34) | — | 3.35 (0.95) (2 wk) | — | — | ||||
| PPT (kPa) | |||||||||
| G1 | 186.32 (68.64) | — | 421.68 (147.09) (2 wk) | — | — | ||||
| G2 | 186.32 (68.64) | — | 274.58 (137.29) (2 wk) | — | — | ||||
| Cervical flexion-extension (°) | |||||||||
| G1 | 47.55 (12.2) | — | 59.8 (6.95) (2 wk) | — | — | ||||
| G2 | 52.2 (7.5) | — | 50.35 (11.35) (2 wk) | — | — | ||||
| Cervical rotation (°) | |||||||||
| G1 | 56.6 (13) | — | 66.8 (2.8) (2 wk) | — | — | ||||
| G2 | 55.4 (11.9) | — | 60.8 (2.65) (2 wk) | — | — | ||||
| Cervical lateral flexion (°) | |||||||||
| G1 | 32.95 (10.65) | — | 43.45 (7.8) (2 wk) | — | — | ||||
| G2 | 36.8 (10.5) | — | 33.55 (9.2) (2 wk) | — | — | ||||
|
| |||||||||
| Stieven et al., 2020 [31] | Pain (NPRS, 0–10) | ||||||||
| G1 | 6.31 (0.72) | — | 2.17 (0.81) (4 wk) | 2.98 (0.63) (12 wk) | 3.26 (0.74) (24 wk) | ||||
| G2 | 6.18 (1.07) | — | 3.37 (1.22) (4 wk) | 3.52 (0.95) (12 wk) | 3.60 (0.56) (24 wk) | ||||
| Disability (NDI, %) | |||||||||
| G1 | 26.52 (9.72) | — | 22.94 (8.891) (4 wk) | 23.08 (11.1) (12 wk) | 24.99 (9.04) (24 wk) | ||||
| G2 | 27.13 (6.42) | — | 20.94 (10.4) (4 wk) | 23.66 (8.91) (12 wk) | 22.86 (7.28) (24 wk) | ||||
| Pain catastrophizing (PCS) | |||||||||
| G1 | 23.67 (9.51) | — | 22.17 (6.04) (4 wk) | 19.07 (7.89) (12 wk) | 19.18 (6.47) (24 wk) | ||||
| G2 | 20.97 (8.56) | — | 21.08 (8.83) (4 wk) | 21.26 (9.41) (12 wk) | 18.94 (8.06) (24 wk) | ||||
|
| |||||||||
| Gallego-Sendarrubias et al., 2020 [28] | Pain (VAS, 0–10) | ||||||||
| G1 | 6.66 (1.4) | 3.19 (1.6) | 1.77 (1.4) (4 wk) | — | — | ||||
| G2 | 6.17 (1.6) | 4.15 (1.9) | 3.34 (1.2) (4 wk) | — | — | ||||
| PPT (kPa) | |||||||||
| G1 | 171.61 (39.22) | 303.02 (78.45) | 355.97 (98.06) (4 wk) | — | — | ||||
| G2 | 184.36 (49.033) | 253.01 (78.45) | 219.66 (68.64) (4 wk) | — | — | ||||
| Disability (NDI) | |||||||||
| G1 | 28.95 (10.2) | 76.81 (12.1) | 4.61 (6.2) (4 wk) | — | — | ||||
| G2 | 23.69 (9.8) | 73.13 (10.5) | 11.52 (7.3) (4 wk) | — | — | ||||
| Cervical flexion (°) | |||||||||
| G1 | 67.89 (13.5) | 64.19 (12.0) | 78.38 (9.5) (4 wk) | — | — | ||||
| G2 | 69.25 (11.1) | 61.92 (11.5) | 70.58 (9.4) (4 wk) | — | — | ||||
| Cervical extension (°) | |||||||||
| G1 | 52.32 (14.6) | 82.60 (14.5) | 69.09 (11.3) (4 wk) | — | — | ||||
| G2 | 55.68 (11.5) | 79.11 (13.2) | 62.40 (10.4) (4 wk) | — | — | ||||
| Right rotation (°) | |||||||||
| G1 | 74.28 (18.1) | 81.45 (13.7) | 87.55 (8.1) (4 wk) | — | — | ||||
| G2 | 74.60 (15.3) | 79.13 (11.5) | 78.79 (10.9) (4 wk) | — | — | ||||
| Left rotation (°) | |||||||||
| G1 | 71.79 (17.7) | 82.02 (14.1) | 87.19 (8.4) (4 wk) | — | — | ||||
| G2 | 73.81 (11.8) | 79.12 (12.35) | 78.89 (10.1) (4 wk) | — | — | ||||
|
| |||||||||
| Gallego-Sendarrubias et al., 2020 [28] | Cervical rotation (°) (mean calculated) | ||||||||
| G1 | 73.03 (17.9) | 59.60 (11.9) | 87.37 (8.25) (4 wk) | — | — | ||||
| G2 | 74.2 (13.55) | 56.28 (11.9) | 78.84 (10.5) (4 wk) | — | — | ||||
| Right cervical lateral flexion (°) | |||||||||
| G1 | 47.72 (14.3) | 62.51 (10.5) | 68.45 (12.5) (4 wk) | — | — | ||||
| G2 | 49.04 (13.1) | 59.87 (10.6) | 56.25 (13.0) (4 wk) | — | — | ||||
| Left cervical lateral flexion (°) | |||||||||
| G1 | 53.64 (10.8) | 61.05 (11.2) | 70.11 (10.8) (4 wk) | — | — | ||||
| G2 | 55.43 (11.0) | 58.07 (11.25) | 59.77 (9.9) (4 wk) | — | — | ||||
| Cervical lateral flexion (mean calculated) | |||||||||
| G1 | 50.68 (12.55) | — | 69.28 (11.65) (4 wk) | — | — | ||||
| G2 | 52.23 (12.05) | — | 58.01 (11.45) (4 wk) | — | — | ||||
| Dry needling combined with other interventions vs. dry needling alone | |||||||||
|
| |||||||||
| León-Hernández et al., 2016 [24] | Pain (VAS, 0–10)+ | ||||||||
| G1 | 5.00 (4.00–6.00) | 2.50 (1.00–4.00) | — | — | — | ||||
| G2 | 5.00 (3.50–6.00) | 2.00 (1.00–5.00) | — | — | — | ||||
| Disability (NDI)+ | |||||||||
| G1 | 9.50 (8.00–13.00) | 6.50 (3.25–10.00) | — | — | — | ||||
| G2 | 11.00 (7.00–14.50) | 6.00 (4.00–14.00) | — | — | — | ||||
| Cervical flexion (°) | |||||||||
| G1 | 52.05 (12.24) | 53.76 (12.07) | — | — | — | ||||
| G2 | 52.42 (11.72) | 51.07 (12.21) | — | — | — | ||||
| Cervical extension (°) | |||||||||
| G1 | 58.62 (11.80) | 62.98 (10.90) | — | — | — | ||||
| G2 | 58.11 (12.44) | 60.26 (13.73) | — | — | — | ||||
|
| |||||||||
| León-Hernández et al., 2016 [24] | Cervical left lateral flexion (°) | ||||||||
| G1 | 38.16 (9.36) | 41.80 (9.63) | — | — | — | ||||
| G2 | 39.05 (8.01) | 39.77 (9.18) | — | — | — | ||||
| Cervical right lateral flexion (°) | |||||||||
| G1 | 37.55 (9.11) | 40.75 (9.91) | — | — | — | ||||
| G2 | 38.77 (10.46) | 40.59 (9.67) | — | — | — | ||||
| Cervical lateral flexion (mean calculated) | |||||||||
| G1 | 37.85 (9.23) | 41.27 (9.77) | — | — | — | ||||
| G2 | 38.91 (9.23) | 40.18 (9.42) | — | — | — | ||||
| Cervical left rotation (°) | |||||||||
| G1 | 59.31 (13.72) | 59.59 (11.98) | — | — | — | ||||
| G2 | 61.40 (12.82) | 64.33 (8.58) | — | — | — | ||||
| Cervical right rotation (°) | |||||||||
| G1 | 60.50 (10.73) | 61.18 (10.9) | — | — | — | ||||
| G2 | 60.36 (10.24) | 62.22 (7.42) | — | — | — | ||||
| Cervical rotation (mean calculated) | |||||||||
| G1 | 59.90 (12.22) | 60.38 (11.44) | — | — | — | ||||
| G2 | 60.88 (11.53) | 63.27 (8) | — | — | — | ||||
|
| |||||||||
| Valiente-Castrillo et al., 2020 [25] | Pain (VAS, 0–10) | ||||||||
| G1 | 5.79 (1.89) | — | 2.38 (1.85) (4 wk) | 3.00 (1.73) (12 wk) | — | ||||
| G2 | 5.52 (1.80) | — | 1.17 (1.12) (4 wk) | 2.47 (2.31) (12 wk) | — | ||||
| G3 (N/A) | 5.26 (1.46) | — | 3.85 (2.38) (4 wk) | 3.91 (2.50) (12 wk) | — | ||||
| Disability (NDI) | |||||||||
| G1 | 17.45 (4.94) | — | 12.00 (5.68) (4 wk) | 11.0 (6.06) (12 wk) | — | ||||
| G2 | 15.80 (4.62) | — | 7.19 (6.56) (4 wk) | 7.57 (5.33) (12 wk) | — | ||||
| G3 (N/A) | 16.78 (5.32) | — | 13.21 (7.26) (4 wk) | 13.78 (8.78) (12 wk) | — | ||||
| Pain catastrophizing (PCS) | |||||||||
| G1 | 16.95 (11.39) | — | 12.10 (11.01) (4 wk) | 11.75 (10.48) (12 wk) | — | ||||
| G2 | 16.55 (12.36) | — | 7.33 (7.90) (4 wk) | 6.61 (7.86) (12 wk) | — | ||||
| G3 (N/A) | 19.41 (11.37) | — | 12.70 (10.95) (4 wk) | 14.70 (10.26) (12 wk) | — | ||||
+Data are expressed as median and interquartile range. They were converted to mean and standard deviation in the forest plots.