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.