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Vol. 23. Issue 4.
Pages 355-363 (01 July 2019)
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Vol. 23. Issue 4.
Pages 355-363 (01 July 2019)
Clinical Trial Protocol
DOI: 10.1016/j.bjpt.2018.10.010
Dry needling in addition to standard physical therapy treatment for sub-acromial pain syndrome: a randomized controlled trial protocol
Ben R. Handoa,d,
Corresponding author

Corresponding author at: Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio, Lackland AFB, TX 78236, United States.
, Daniel I. Rhonb,d, Joshua A. Clelandc, Suzanne J. Snodgrassd
a Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio, Lackland, TX, United States
b Baylor University, Doctoral Program in Physical Therapy, Waco, TX, United States
c Department of Physical Therapy, Franklin Pierce University, Manchester, NH, United States
d Discipline of Physiotherapy, The University of Newcastle, Callaghan, NSW, Australia

  • Few studies have assessed long term effects of TPDN for individuals with SAPS.

  • This study assesses the value of adding TPDN to routine treatments for SAPS.

  • This study assesses the effect of TPDN on subsequent healthcare utilization.

  • Results from this work could inform clinical management of SAPS.

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Table 1. Inclusion and exclusion criteria.
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Trigger point dry needling interventions are utilized by physical therapists to manage shoulder pain. Observational studies have shown positive short-term outcomes in patients with subacromial pain syndrome receiving trigger point dry needling. However, little research has been done to evaluate the long-term effectiveness of trigger point dry needling specifically as it compares to other commonly utilized interventions such as exercise and manual therapy. The purpose of this study is to assess the additive short and long-term effectiveness of trigger point dry needling to a standard physical therapy approach of manual therapy and exercise for patients with subacromial pain syndrome.


This multicenter randomized trial with 3 arms was designed following the standard protocol items for randomized interventional trials. Results will be reported consistent with the consolidated standards of reporting trials guidelines. 130 participants will be randomized to receive standard PT interventions alone (manual therapy and exercise), standard PT and trigger point dry needling or standard PT and sham trigger point dry needling. The primary outcome measures will be the Shoulder Pain and Disability Index and Patient Reported Outcomes Measurement Information Systems (PROMIS-57) scores collected at baseline, 6-weeks, 6-months and one year. Healthcare utilization will be collected for 12 months following enrollment and groups analyzed for differences.


It is not known if trigger point dry needling provides long-term benefit for individuals with subacromial pain syndrome. This study will help determine if this intervention provides additive benefits over those observed with the commonly applied interventions of exercise and manual therapy.

Trial registration

Identifier: NCT03442894 ( on 22 February 2018.

Shoulder pain
Subacromial pain syndrome
Physical therapy
Subacromial impingement syndrome
Manual therapy


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