Periosteal Electrical Dry Needling for Knee Osteoarthritis

Patients with knee osteoarthritis will be randomized to receive periosteal electrical dry needling 1-2 treatments per week for 6 weeks (up to 10 sessions total) followed by either: 1. no maintenance treatments, 2. one maintenance treatment every other month or 3. one maintenance treatment per month.

Inclusion criteria

• Adult over the age of 18 years old:
• 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) (sensitivity = 95% / specificity = 69%)

• 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 physical therapy, massage therapy, chiropractic treatment, or injections for knee pain in last 4 weeks.
• History of a partial or total knee replacement on the painful lower extremity.
• History of a surgical procedure on either lower extremity in last 12 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 periosteal electric dry needling
• The patient is pregnant.