Inclusion criteria:
Age range: 18 to 40 years
Complaint of anterior knee pain (pain around or behind the patella) that was not related to trauma and had persisted for at least 3 months.
The intensity of knee pain in the past week, according to the Numeric Pain Rating Scale (NPRS), reported by the patient: between 3 and 6
Report of pain during at least two load-bearing activities on the patellofemoral joint, including: ascending or descending stairs, squatting, prolonged sitting with the knee flexed, jumping activities, and running
Positive Clarke's sign test
Score on the Kujala Anterior Knee Pain Scale (AKPS): less than 80
Completion of the informed consent form
Exclusion criteria:
Osteoarthritis
Ligament or meniscus injury
Patellar instability, plica syndrome, Osgood-Schlatter disease, and Sinding-Larsen-Johansson syndrome
Obvious structural deformities and known pathological conditions in the lower back, hip, and ankle
Diagnosis of metabolic or neurological diseases such as diabetes or radicular pain
Contraindications for dry needling, such as cardiovascular disease, coagulation disorders, use of anticoagulant medications, pregnancy, cancer, or needle phobia
Receiving physiotherapy for knee pain within the past year
History of knee surgery
Receiving acupuncture, injection, or dry needling therapy for the knee or quadriceps muscles within the past 6 months
Medical history of bleeding disorders
Presence of central or peripheral neurological pathology