Effects of dry needling of the obliquus capitis inferior on sensorimotor control and cervical mobility in people with neck pain: a double-blind, randomized sham-controlled trial

Carlos Murillo, Julia Treleaven, Barbara Cagnie, Javier Peral, Deborah Falla, Enrique Lluch

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Impairments of sensorimotor control relating to head and eye movement control and postural stability are often present in people with neck pain. The upper cervical spine and particularly the obliquus capitis inferior (OCI) play an important proprioceptive role; and its impairment may alter cervical sensorimotor control. Dry needling (DN) is a valid technique to target the OCI.

OBJECTIVES: To investigate if a single DN session of the OCI muscle improves head and eye movement control-related outcomes, postural stability, and cervical mobility in people with neck pain.

METHODS: Forty people with neck pain were randomly assigned to receive a single session of DN or sham needling of the OCI. Cervical joint position error (JPE), cervical movement sense, standing balance and oculomotor control were examined at baseline, immediately post-intervention, and at one-week follow-up. Active cervical rotation range of motion and the flexion rotation test were used to examine the global and upper cervical rotation mobility, respectively.

RESULTS: Linear mixed-models revealed that the DN group showed a decrease of JPE immediately post-intervention compared to the sham group (mean difference [MD]= -0.93°; 95% confidence interval [CI]: -1.85, -0.02) which was maintained at one-week follow-up (MD= -1.64°; 95%CI: -2.85, -0.43). No effects on standing balance or cervical movement sense were observed in both groups. Upper cervical mobility showed an increase immediately after DN compared to the sham group (MD= 5.14°; 95%CI: 0.77, 9.75) which remained stable at one-week follow-up (MD= 6.98°; 95%CI: 1.31, 12.40). Both group showed an immediate increase in global cervical mobility (MD= -0.14°; 95%CI: -5.29, 4.89).

CONCLUSION: The results from the current study suggest that a single session of DN of the OCI reduces JPE deficits and increases upper cervical mobility in patients with neck pain. Future trials should examine if the addition of this technique to sensorimotor control training add further benefits in the management of neck pain.

Original languageEnglish
Pages (from-to)826-836
JournalBrazilian journal of physical therapy
Issue number6
Early online date5 Sept 2021
Publication statusE-pub ahead of print - 5 Sept 2021

Bibliographical note

Funding Information:
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The study was approved by the Ethical Committee at University of Valencia, Spain (reference number H1542206264486) and was prospectively registered in ClinicalTrial.gov with registration number NCT03838224.

Publisher Copyright:
© 2021 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia


  • Dry needling
  • Flexion-rotation test
  • Neck pain
  • Obliquus capitis inferior
  • Sensorimotor function

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation


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