Efficacy of the use of special physical exercises to increase the functionality of the neck in combination with dry needling, shockwave therapy and conventional physiotherapy for head and neck pain: a randomized controlled study

Background and purpose Myofascial pain syndrome is a common condition that causes persistent pain in the neck and head, often making everyday movements difficult and limiting daily life. In this study, we’ll explore which treatment works best, dry needling, shockwave therapy, or convectional physiotherapy, when combined with targeted exercises. Over five sessions, we’ll measure how well each approach reduces pain, boosts muscle strength, and improves flexibility. Material and methods We enrolled 99 people with chronic head and neck pain and divided them randomly into three groups. The first group received standard physiotherapy along with targeted exercises, the second group got dry needling in addition to standard therapy and exercises, and the third group received shockwave therapy combined with the same standard physiotherapy and exercise. To measure progress, we looked at pain perception (using the Pain Catastrophizing Scale), neck function (via the Neck Disability Index), muscle strength, and range of motion. Results The best results in lateral flexion (p < 0.001, p = 0.004) and in neck extensor strength (p = 0.043) showed dry needling (DN) with standard physiotherapy and a standardized exercise program (active cervical movements, isometric strengthening, and stretching). However, it was less effective in reducing neck disability (NDI) compared to Shockwave Therapy (SW) combined with physiotherapy and to standard Physiotherapy (SP) alone (p < 0.001), possibly due to temporary discomfort at the start of treatment. All three groups followed the same exercise regimen to maintain consistency. Conclusions Shockwave therapy (SW) delivered the best results overall. It not only boosted neck strength and flexibility more than dry needling (DN) and standard physiotherapy (SP), but also made a bigger difference in reducing neck-related limitations in daily life. DN also improved cervical flexor strength and lateral mobility. All groups followed the same structured exercise program. While SP was beneficial, it was less effective than shock wave and dry needling in most measures.