Objective: This study aimed to investigate the influence of potential placebo and nocebo effects on pain perception of percutaneous needle electrolysis (PNE) in individuals with patellar tendinopathy.
Methods: In this secondary analysis of a three-arm randomized double-blinded controlled trial, intra and inter-session pain perception data from 48 sporting participants with patellar tendinopathy between 18 and 45 years were investigated. Participants were divided into 3 parallel groups: "no-sham group" [PNE intervention], "single-sham group" [sham PNE by using dry needling], and "double-sham group" [sham PNE by using sham needles]. Every group received 4 sessions of the needling therapies targeting the patellar tendon over 8 weeks and was instructed to perform a unilateral eccentric exercise program of the quadriceps muscle on the affected side. Clinical and needle-related pain was assessed before, during, and after each treatment session using a visual analog scale.
Results: No differences were found between groups intra- or inter-session in terms of pain reduction ( = 0.424) despite clinical pain decreased in all groups since the first treatment session ( < 0.001). Furthermore, although the double-sham group showed a lower percentage of participants reporting needle-related pain during needle intervention ( = 0.005), the needle-related pain intensity after needle intervention was similar between groups ( = 0.682). Moreover, there were no group differences for the duration of pain sensation after any needle intervention ( = 0.184), extending in many cases beyond 24 h.
Conclusion: Needling therapies for individuals with patellar tendinopathy are prone to elicit placebo effects regarding clinical pain and nocebo effects regarding needling-related pain. Clinicians and physical therapists treating musculoskeletal pain conditions should consider the added value and potential mechanisms of action before routinely using needle techniques.
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| http://dx.doi.org/10.3389/fmed.2024.1381515 | DOI Listing |
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