Neck pain driven by myofascial trigger points — those tight, tender knots in the muscle — is one of the most common reasons people seek hands-on treatment. This trial set out to compare two well-established, non-drug approaches head to head: dry needling and TENS (transcutaneous electrical nerve stimulation, a small device that delivers a gentle electrical current through pads on the skin).
Fifty patients with neck pain from myofascial trigger points were randomly split into two groups: one received dry needling, the other TENS. Each person was assessed three times — before treatment, then at 14 and 28 days — using a pain scale (the Visual Analog Scale), a neck disability questionnaire (the Neck Disability Index) and a measure of how far they could move their neck (cervical range of motion).
Both dry needling and TENS are widely used for myofascial neck pain, but they’re rarely compared directly. A head-to-head trial helps clinicians and patients understand what each can realistically achieve, and where one may have an edge.
A fine needle is inserted directly into the trigger point in the muscle, aiming to release the taut band, ease pain and improve movement.
Adhesive pads placed on the skin deliver a low-level electrical current, which is thought to reduce pain signalling and provide symptomatic relief without needles.
Both treatments helped — and one showed a slight edge on pain.
Over 28 days, both the dry needling and TENS groups showed significant improvements in pain, neck disability and range of motion compared with their starting point.
Neck disability scores fell and cervical range of motion increased in both groups, pointing to better day-to-day function, not just less pain.
The authors reported that the dry needling group achieved greater improvements in pain than the TENS group.
With 50 patients at one centre and a 28-day window, the results are encouraging but limited — larger, longer studies are needed to confirm them.
For neck pain caused by myofascial trigger points, both dry needling and TENS reduced pain and disability and improved movement over four weeks — with dry needling showing a somewhat greater improvement in pain. Both are reasonable options; needling may have a slight edge.
Trigger-point neck pain is bread-and-butter work in these clinics. This trial supports dry needling as an effective option for it, while also validating a gentler, needle-free alternative in TENS for people who prefer not to be needled or aren’t suited to it.
The practical message is choice: two evidence-backed tools, both effective over the short term, that can be matched to the individual client and often combined with hands-on treatment and exercise.
Clinical relevance by discipline
Directly supports needling of trigger points for myofascial neck pain, with a slight edge over TENS on pain in this trial — best used as part of a broader plan rather than in isolation.
Reinforces trigger-point dry needling as a core tool for neck pain, and offers a needle-free option (TENS) for clients who prefer it.
Both modalities improved neck disability and range of motion, fitting neatly alongside active rehabilitation for mechanical neck pain.
A useful evidence point when explaining to clients why targeted trigger-point work matters, and when coordinating care with needling or electrotherapy.
This was a small, single-centre trial of 50 patients with a relatively short follow-up of 28 days, so it can’t tell us how long the benefits last or how the treatments perform in larger, more varied populations. As with most needle and electrotherapy studies, blinding is difficult, which can influence self-reported outcomes like pain. The results are best read as promising and consistent with the wider evidence, rather than the final word.
Larger trials with longer follow-up would help confirm both the size of the benefit and whether dry needling’s edge on pain holds up over time.
In 50 patients with neck pain from myofascial trigger points, both dry needling and TENS significantly reduced pain and disability and improved neck movement over four weeks, with dry needling showing a somewhat greater improvement in pain. Both are effective short-term options.
For myotherapists, physiotherapists and remedial massage therapists, this supports dry needling as an effective choice for trigger-point neck pain while validating TENS as a gentler alternative — ideally matched to the individual and combined with hands-on care and exercise.
Efficacy of Dry Needling Versus Transcutaneous Electrical Nerve Stimulation in Patients With Neck Pain Due to Myofascial Trigger Points: A Randomized Controlled Trial and Anjana G, et al. Cureus, 2023; 15(3): e36473.
