Dry Needling Versus Conventional Physical Therapy in Patients With Knee Osteoarthritis

Patients with knee OA will be randomized to receive 1-2 treatments per week for 6 weeks (up to 10 sessions total) of either: (1) Dry Needling and conventional physical therapy or the (2) Conventional physical therapy (manual physical therapy, exercise, range of motion and stretching)

Inclusion criteria

• Report of knee pain of at least 2/10 per NPRS (0---10 scale) for >3 months
• Report of at least 3 of the following per Altman et al. (1986)

• Over 50 Years of age
• Less than 30 minutes of morning stiffness
• Crepitus on active motion
• Bony tenderness
• Bony enlargement
• No palpable warmth of synovium

Exclusion criteria

• Report of red flags to manual physical therapy to include: hypertension, infection, diabetes, peripheral neuropathy, heart disease, stroke, chronic ischemia, edema, severe varicosities, tumor, metabolic disease, prolonged steroid use, fracture, RA, osteoporosis, severe vascular disease, malignancy, etc.
• History of previous surgery to the knee
• History of physical therapy, massage therapy, chiropractic treatment, or injections for knee pain in the last 4 weeks
• History of a surgical procedure on either lower extremity in last 6 months
• Two or more positive neurologic signs consistent with nerve root compression, including any two of the following:

• Weakness involving a major muscle group of the lower extremity.
• Diminished patella or achilles tendon reflex
• Diminished or absent sensation to pinprick in lower extremity dermatome
• Involvement in litigation or worker's compensation regarding knee pain.
• Any condition that might contraindicate the use of electro-needling
• The patient is pregnant.