Does Dry Needling Affect Treatment Outcomes of Interlaminar Epidural Steroid Injection in Cervical Disc Herniation?
Pain, Myofacial, Pain, Neck, Pain, Chronic
About this trial
This is an interventional treatment trial for Pain, Myofacial focused on measuring myofascial trigger point pain, disc, herniated, epidural injections
Eligibility Criteria
Inclusion Criteria:
- Between the ages of 18-65
- Chronic neck pain due to cervical disc herniation for at least 3 months and being unresponsive to conservative treatment
- Presence of at least one active myofascial trigger point on physical examination of cervical paraspinal muscles, scapulothoracic muscles and extremity muscles.
Exclusion Criteria:
- Previous surgical/interventional procedure for the cervical region
- Previous application of dry needling/acupuncture to any part of the body
- Presence of other musculoskeletal disorders (such as lateral epicondylitis, tendinitis, entrapment neuropathy) that may cause diagnostic confusion in terms of pain pattern and localization
- Signs of trauma, fracture, malignancy, or active infection
- Rheumatological (RA, AS, etc.), endocrinological (such as osteoporosis, Paget's disease) or another systemic disease that may change the anatomical or physiological structure of the relevant regions
- Presence of coagulopathy
- History of whiplash injury, cervical spinal stenosis, cervical spondylosis
- Have a diagnosis of fibromyalgia
- Being pregnant and breastfeeding
- Presence of mental deterioration or psychiatric/neurological disease that can affect flow of the study.
Sites / Locations
- Marmara University Pendik Education and Research Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Active Comparator
Sham Comparator
Other
interlaminar epidural steroid injection plus dry needling
interlaminar epidural steroid injection plus sham dry needling
interlaminar epidural steroid injection only
Fluoroscopy-guided cervical interlaminar epidural steroid injection will be administered to patients with chronic neck pain due to cervical disc herniation. Also, dry needling will be applied to the active trigger points for the patients in this group. Interlaminar epidural steroid injection will be applied at week 0, while dry needling will be applied in 3 sessions per week (week 0, week 1, week 2). The first session of the dry needling will be in the same day with interlaminar epidural steroid injection.
Fluoroscopy-guided cervical interlaminar epidural steroid injection will be administered same as the arm titled "interlaminar epidural steroid injection plus dry needling". The only difference in the interventions in this arm is that dry needling is applied without penetrating the skin. The blunt tip of the needle will be used in sham intervention. Interlaminar epidural steroid injection will be applied at week 0, while sham dry needling will be applied in 3 sessions per week (week 0, week 1, week 2)
Only interlaminar epidural steroid injection will be administered to patients in this arm with the same method as in the other arms (one session, week 0). No dry needling or sham dry needling will be used.