Comparative Effectiveness of Deep and Superficial Dry Needling for Myofascial Trigger Points in Neck Pain: A Systematic Review of Randomised Clinical Trials

Background: Research examining the difference between the effects of deep and superficial dry needling on myofascial trigger points (MTrPs) in the upper trapezius muscle is limited. Thus, this systematic review was conducted to compare the effects of these two dry-needling techniques on pain and functional disability in adults with neck pain who demonstrated MTrPs. Methods: Randomised clinical trials (RCTs) were identified through an electronic search in PubMed, Scopus, Web of Science, Embase, Google Scholar, Dimensions and OpenAlex from inception until September 22, 2024. Only English-language studies were considered. Best-evidence synthesis was utilised to interpret the results of the included RCTs. Results: Of the 192 records obtained, eight RCTs were included (two with a low risk of bias, four with some risk-of-bias concerns and two with a high risk of bias). Overall, both deep and superficial dry needling provided short-term alleviation of pain and functional disability. No clinically meaningful differences were found between the two dry-needling techniques. Conclusion: Deep and superficial dry needling seem to have similar positive effects on pain and functional disability in patients with neck pain exhibiting MTrPs.