Electrical Dry Needling and Therapeutic Exercise Versus Therapeutic Exercise in Patients With Chronic Nonspecific Neck Pain: Protocol for a Randomized Controlled Trial

Background: Chronic nonspecific neck pain (CNSNP) is one of the most prevalent musculoskeletal disorders worldwide. Its etiology is multifactorial, and it constitutes a leading cause of work absenteeism and a significant socioeconomic burden. Therapeutic exercise, strongly supported by scientific evidence, is considered the cornerstone physiotherapy intervention for its management. In recent years, electrical dry needling (EDN) has been increasingly applied in musculoskeletal disorders with the aim of modulating pain and improving function. Objective: This protocol aims to compare the effectiveness of EDN combined with therapeutic exercise versus therapeutic exercise alone in patients with CNSNP. Methods: A randomized, controlled, examiner-blinded clinical trial with 2 parallel intervention arms will be conducted with 70 participants diagnosed with CNSNP, recruited from the outpatient physical therapy department of the University of Almería. Participants will be randomly allocated (1:1) into 2 groups: the experimental group will receive EDN combined with therapeutic exercise (n=35), while the control group will undergo a program of therapeutic exercise alone (n=35). Both groups will receive 1 session per week for 6 weeks (6 sessions in total). Primary and secondary outcome measures will include cervical disability, pain intensity, sleep quality, health-related quality of life, kinesiophobia, pain catastrophizing, cervical range of motion, pressure pain threshold at myofascial trigger points, and cervical muscle endurance. Assessments will be performed at 3 time points: baseline, postintervention, and 2-month follow-up. Results: This study was funded in 2023. Participant recruitment was conducted between November and December 2025. As of January 2026, 35 of the planned 70 participants had been recruited. Data collection is expected to be completed by March 2026. Data analysis and manuscript preparation will be carried out during 2026, with results anticipated to be published in late 2026. Conclusions: This trial will provide evidence on the effectiveness of combining EDN with therapeutic exercise in CNSNP, potentially informing clinical practice and improving patient outcomes.