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American authors have evaluated the effects of deep versus superficial needling on pain and disability for spine-related painful conditions. Twelve manuscripts were included in their systematic review and ten in their meta-analysis. Both superficial (<10 mm) and deep needling (>10 mm) resulted in clinically meaningful changes in pain scores over time. Deep needling was found to be more beneficial with regard to pain reduction than superficial needling, with statistically significant between-group differences observed favoring deep needling, however the authors note that the size of the differences observed between groups may not be clinically meaningful.

The effectiveness of superficial versus deep dry needling or acupuncture for reducing pain and disability in individuals with spine-related painful conditions: a systematic review with meta-analysis. J Man Manip Ther. 2019 Mar 19:1-13