Scar dry needling for tissue compliance in individuals with linear scars: a randomized controlled trial.

BACKGROUND: Evidence for dry needling (DN) in scar management remains limited. OBJECTIVE: To compare scar-DN with minimal needling for tissue compliance, local scar-related pain, passive knee flexion, and health-related quality of life in individuals with linear scars. DESIGN: A single-center, assessor-blinded, randomized controlled trial. METHODS: Eighty participants were randomized to scar-DN or minimal needling away from the scar; both groups also received kinesiology taping and infrared therapy. The primary outcome was tissue compliance at 5-, 10-, and 15-mm indentation depths. Secondary outcomes were local scar-related pain, passive knee flexion in participants with anterior knee scars, and SF-36 physical and mental component scores. Assessments occurred at baseline, post-treatment, and two weeks. RESULTS: Compared with minimal needling, scar-DN was associated with greater tissue compliance at the 5-mm depth immediately after treatment (adjusted mean difference [MD], -4.51 N; 95% CI, -6.48 to -2.54), at the 10-mm depth immediately after treatment (-6.24 N; 95% CI, -9.20 to -3.28) and follow-up (-9.84 N; 95% CI, -14.60 to -5.07), and at the 15-mm depth at follow-up (-6.68 N; 95% CI, -10.70 to -2.65). Differences at the remaining depth-time combinations were not statistically significant. No statistically significant or clinically meaningful between-group difference was found in local scar-related pain (n = 28), although this analysis was underpowered because pain was not present in all participants. No significant between-group differences were found in SF-36 physical or mental component scores. Passive knee flexion favored scar-DN, but this exploratory analysis included only 14 participants. CONCLUSIONS: Scar-DN was associated with short-term improvements in tissue compliance at some indentation depths. The clinical importance and durability of these findings remain uncertain; no between-group differences were identified in local scar-related pain or health-related quality of life. CLINICAL TRIAL REGISTRY NUMBER: IRCT20130409012953N4, NCT06033430.