Neck pain is the second most common physical therapy diagnosis seen in outpatient clinics and is frequently associated with myofascial trigger points (MTrPs). MTrPs are treated directly with dry needling and manual mobilization. However, it is unclear if one technique is superior to the other. The purpose of this study is to discover in a young, active patient with chronic neck pain, if dry needling is more effective than manual mobilization in decreasing pain and improving function.

Case Description

The patient presented to an outpatient orthopedic clinic with reports of neck pain greater than 6 months. The patient was a young and active graduate student who bicycled and participated in recreational exercise. The patient exhibited decreased cervical range of motion and many MTrPs. Insurance approved four visits to therapy, allowing minimal time for treatment.


PubMed, PEDro, and CINAHL databases were searched for articles pertaining to dry needling, manual therapy, and neck pain. A total of thirty-one articles were narrowed down to eight. The eight articles were examined and evaluated to compile evidence to address the PICO question. Regarding the patient in clinic, both interventions were provided to the patient throughout their physical therapy treatment.


There is no strong evidence to unequivocally say if dry needling is a superior treatment to manual mobilization for treating chronic neck pain in a young, active patient. The literature and case study support the use of both interventions in conjunction to achieve the best outcome possible.



Document Type


Degree Name

Doctor of Physical Therapy (DPT)

Level of Degree


First Advisor

Tiffany Enache, PT, DPT


dry needling, manual therapy, mobilization, neck pain, trigger points