The effect of combined dry needling and stretching exercises on pain and function in patients with patellofemoral pain: A randomized clinical trial.

Comparison of pressure release, phonophoresis and dry needling in treatment of latent myofascial trigger point of upper trapezius muscle.

Added Value of Gluteus Medius and Quadratus Lumborum Dry Needling in Improving Knee Pain and Function in Female Athletes With Patellofemoral Pain Syndrome: A Randomized Clinical Trial

Comparison of the effectiveness between dry needling with and without needle retention in myofascial trigger points in upper trapezius muscle: A randomized comparative trial

Chronic musculoskeletal disorders in the shoulder joint are often associated with myofascial trigger points (MTrPs), particularly in the upper trapezius (UT) muscle. Dry needling (DN) is a treatment of choice for myofascial pain syndrome. However, local lesions and severe postneedle soreness sometimes hamper the direct application of DN in the UT. Therefore, finding an alternative point of treatment seems useful in this regard. To compare the efficacy of UT versus infraspinatus (ISP) DN on pain and disability of subjects with shoulder pain. The authors hypothesized that ISP DN could be as effective as the direct application of DN in UT MTrP. Single-blind randomized clinical trial. Sports medicine physical therapy clinic. A total of 40 overhead athletes (age = 36 [16]y; 20 females and 20 males) with unilateral shoulder impingement syndrome were randomly assigned to the UT DN (n = 21) and ISP DN (n = 19) groups. An acupuncture needle was directly inserted into the trigger point of UT muscle in the UT DN group and of ISP muscle in the ISP DN group. DN was applied in 3 sessions (2-day interval between each sessions) for each group. Pain intensity (visual analog scale), pain pressure threshold, and disability in the arm, shoulder, and hand were assessed before and after the interventions. Pain and disability decreased significantly in both groups (P < .001) and pain pressure threshold increased significantly only in the ISP group (P = .02). However, none of the outcome measures showed a significant intergroup difference after treatments (P > .05). Application of DN for active MTrPs in the ISP can be as effective as direct DN of active MTrPs in the UT in improving pain and disability in athletes with shoulder pain, and may be preferred due to greater patient comfort in comparison with direct UT needling.

The aim of this study was to compare the effectiveness of kinesio taping (KT) and dry needling (DN) in the treatment of myofascial pain syndrome (MPS) of the trapezius muscle. The patients with MPS were divided into 3 groups as those who received exercise only (control group), those who received KT and exercise (KT group) and those who received DN and exercise (DN group) by using a sealed opaque envelope randomisation method. Visual Analog Scale (VAS), Pressure Pain Threshold (PPT), Neck Disability Index (NDI) and Global Perceived Effect Scale (GPES) were measured twice at baseline and at the end of the second week by blinded evaluator. A total of 26 patients were assigned to KT group, 32 to DN group and 30 to control group. The results of the study showed that PPT, VAS and NDI scores were significantly improved in the KT (1.61±1.25, -2.66±1.24 and -7.08±6.24, respectively) and DN (1.30±1.13, -3.34±1.40 and -10.63±7.80 respectively) groups (P<.001 for all). In the control group, no significant improvement was found in the VAS (.10±1.39) and NDI (-.83±4.91) scores (P>.05), with a significant decrease in PPT (-.98±1.92) (P=.014). KT and DN methods in MPS treatment have more positive effects in terms of pain, disability and global effect compared to the control group. In the treatment of MPS, adding DN or KT to exercise programme may provide important contributions to the treatment.

PurposeMyofascial pain syndrome (MPS) is a common musculoskeletal disorder among young adults associated with presence of myofascial trigger points. We aimed to evaluate efficacy of ozone injection (OI) in MPS patients, compared with two currently used methods including lidocaine injection (LI) and dry needling (DN).Patients and methodsIn this single-blinded study, a total of 72 eligible patients were included and then randomly divided into three equal groups: DN, OI, and LI. All patients received treatment in three weekly sessions. Visual analog scale (VAS) for pain, cervical lateral flexion, pain pressure threshold (PPT), and neck disability index (NDI) were the main outcome measures, which were evaluated at baseline and at 4 weeks after injections. Analytic results were demonstrated as both within- and between-groups mean difference (MD).ResultsSixty two patients finished the study, 20 participants in both the DN and LI groups, and 22 persons in OI group. Distribution of all demographics and baseline clinical variables were relatively similar among groups. All three interventions were remarkably effective in improving patients’ pain and PPT. Significant decrease in VAS (MD=–3.6±1.4) and increase in PPT (MD=7.2±5.1) within 4 weeks follow-up confirmed this finding. Also, NDI had similar significant improvement (MD=–9.9±8.7), but lateral flexion range did not show remarkable increase. There was also a statistically significant difference among three methods’ efficacy on VAS, NDI, and PPT, favoring OI and LI.ConclusionIn summary, this data showed that in short-term follow-up, all three methods were significantly effective in MPS treatment; however, OI and LI groups had slightly better results than the DN group, with no remarkable preference between them.

Procedures such as dry needling (DN) or percutaneous electrical nerve stimulation (PENS) are commonly proposed for the treatment of myofascial trigger points (MTrP). The aim of the present study is to investigate if PENS is more effective than DN in the short term in subjects with mechanical neck pain. This was an evaluator-blinded randomized controlled trial. Subjects were recruited through announcements and randomly allocated into DN or PENS groups. Pain intensity, disability, pressure pain threshold (PPT), range of motion (ROM), and side-bending strength were measured. The analyses included mixed-model analyses of variance and pairwise comparisons with Bonferroni correction. The final sample was composed of 44 subjects (22 per group). Both groups showed improvements in pain intensity (ηp2 = 0.62; p < 0.01), disability (ηp2 = 0.74; p < 0.01), PPT (ηp2 = 0.79; p < 0.01), and strength (ηp2 = 0.37; p < 0.01). The PENS group showed greater improvements in disability (mean difference, 3.27; 95% CI, 0.27–6.27) and PPT (mean difference, 0.88–1.35; p < 0.01). Mixed results were obtained for ROM. PENS seems to produce greater improvements in PPT and disability in the short term.

The effect of dry needling on pain, pressure pain threshold and disability in patients with a myofascial trigger point in the upper trapezius muscle

To determine if adding dry needling to a four-week exercise program has an additional benefit compared with adding sham dry needling to the same exercise program in subjects with chronic low back pain. Randomized clinical trial. Physiotherapy and Pain Clinic of Alcala University. Forty-six patients with chronic low back pain. Subjects were randomized to two groups: the dry needling group (N = 23) or sham dry needling group (N = 23). Both groups received a four-week exercise program and before the exercise started a session of dry needling or sham dry needling. Pain (visual analog scale), disability (Roland-Morris Questionnaire), and fear avoidance beliefs (Fear Avoidance Beliefs Questionnaire) were assessed at baseline, after treatment, and at three-month follow-up. Pressure pain thresholds (algometer) were measured at baseline, after the dry needling or the sham dry needling, and after treatment. Both groups showed significant improvements for all variables. In the between-group comparison, the dry needling group improved significantly in pain at three-month follow-up and pressure pain thresholds at the end of treatment for all measures, and at three-month follow-up there was no improvement in gluteus medium. In chronic low back patients, adding dry needling to a four-week exercise program has an additional benefit in pain and sensitivity compared with adding sham dry needling to the same exercise program.

Purpose and Hypothesis: Trigger points (TrP) is one of the most common causes of musculoskeletal disorders. Myofascial trigger point in vastus lateralis muscle has been reported high prevalently in subjects with patellofemoral pain syndrome. The purpose of this study was to investigate the effects of dry needling and kinesio tape on trigger point in vastus lateralis muscle. Randomized controlled trial designed to investigate the effect of Dry Needling (DN) and Kinesio Taping (KT) on pain intensity and knee disability after session’s treatment in individuals with trigger point (TrP) in Vastus Lateralis (VL) muscle. Methods: 30 subjects with TrP in the VL muscle participated in this study. Subjects were randomly assigned to a DN group ([Formula: see text]) or KT group ([Formula: see text]). Results: Statistical analysis (paired [Formula: see text]-test) revealed a significant improvement in VAS during activity and KOOS scores after three sessions treatment in both of groups compared with before treatment ([Formula: see text]). But PPT was not increased after one week treatment. VAS using an algometer was decreased only at DN group ([Formula: see text]). The results showed no significant changes in variables immediately after intervention. The ANCOVA revealed no significant differences between the DN and KT groups on the post-measurement VAS during activity, VAS using an algometer, PPT, KOOS scores ([Formula: see text]). Conclusion: DN and KT produce an improvement in pain intensity and knee disability and may be prescribed for PFPS subjects with TrP in VL muscle especially when pain relief is the goal of the treatment.

Background: The presence of latent myofascial trigger points (MTrPs) in the gluteus medius is one of the possible causes of non-specific low back pain. Dry needling (DN) and ischemic compression (IC) techniques may be useful for the treatment of these MTrPs. Methods: For this study, 80 participants were randomly divided into two groups: the dry needling group, who received a single session of DN to the gluteus medius muscle plus hyperalgesia (n = 40), and the IC group, who received a single session of IC to the gluteus medius muscle plus hyperalgesia (n = 40). Pain intensity, the pressure pain threshold (PPT), range of motion (ROM), and quality of life were assessed at baseline, immediately after treatment, after 48 h, and one week after treatment. Results: Statistically significant differences were shown between the two groups immediately after the intervention, showing a decrease in PPT (p < 0.05) in the DN group and an increase in PPT in the IC group. These values increased more and were better maintained at 48 h and after one week of treatment in the DN group than in the IC group. Quality of life improved in both groups, with greater improvement in the DN group than in the IC group. Conclusions: IC could be more advisable than DN with respect to UDP and pain intensity in the most hyperalgesic latent MTrPs of the gluteus medius muscle in subjects with non-specific low back pain, immediately after treatment. DN may be more effective than IC in terms of PPT, pain intensity, and quality of life in treating latent plus hyperalgesic gluteus medius muscle MTrPs in subjects with non-specific low back pain after 48 h and after one week of treatment.

Treatment of active myofascial trigger points includes both invasive and non-invasive techniques. To compare the effects of upper trapezius trigger point dry needling (DN) and strain-counterstrain (SCS) techniques versus sham SCS. Randomised controlled trial. 34 study subjects with active trigger points were randomly assigned to one of three treatment groups, and received either three sessions of DN (n=12), six sessions of SCS (n=10), or sham SCS (n=12) over a 3-week period. Subjective pain response and subjects' own ratings of perceived disability were measured. The analysis of variance mixed model showed a significant time effect for pain (p<0.001), elicited pain (p<0.001), pain pressure threshold (p<0.01), and neck disability index (p=0.016). Pain at rest decreased in all groups, as follows: DN 18.5 mm (95% CI 4.3 to 32.7 mm); SCS 28.3 mm (95% CI 12.4 to 44.1 mm); sham SCS 21.9 mm (95% CI 3.5 to 40.1 mm). Reductions in disability score (points) were significant in the SCS group (5.5, 95% CI 1.6 to 9.4) but not in the DN (1.4, 95% CI -4.9 to 2.1) or sham SCS (1.8, 95% CI -6.4 to 2.7) groups. There was no significant group×time interaction effect for any variables studied. There were no differences between the sham SCS, SCS, and DN groups in any of the outcome measures. DN relieved pain after fewer sessions than SCS and sham SCS, and thus may be a more efficient technique. Future studies should include a larger sample size. NCT01290653.

BACKGROUNDUnilateral patellofemoral pain syndrome (PFPS) is the most frequently diagnosed knee condition in populations aged < 50 years old. Although the treatment of myofascial trigger points (MTrPs) is a common and effective tool for reducing pain, previous studies showed no additional benefits compared with placebo in populations with PFPS. Percutaneous electrolysis is a minimally invasive approach frequently used in musculotendinous pathologies which consists of the application of a galvanic current through dry needling (DN).AIMTo evaluate changes in sensitivity, knee pain perception and perceived pain during the application of these three invasive techniques.METHODSA triple-blinded, pilot randomized controlled trial was conducted on fifteen patients with unilateral PFPS who were randomized to the high-intensity percutaneous electrolysis (HIPE) experimental group, low-intensity percutaneous electrolysis (LIPE) experimental group or DN active control group. All interventions were conducted in the most active MTrP, in the rectus femoris muscle. The HIPE group received a 660 mA galvanic current for 10 s, the LIPE group 220 mA × 30 s and the DN group received no galvanic current. The MTrP and patellar tendon pain pressure thresholds (PPTs) and subjective anterior knee pain perception (SAKPP) were assessed before, after and 7 d after the single intervention. In addition, perceived pain during the intervention was also assessed. RESULTSBoth groups were comparable at baseline as no significant differences were found for age, height, weight, body mass index, PPTs or SAKPP. No adverse events were reported during or after the interventions. A significant decrease in SAKPP (both HIPE and LIPE, P < 0.01) and increased patellar tendon PPT (all, P < 0.001) were found, with no differences between the groups (VAS: F = 0.30; η2 = 0.05; P > 0.05; tendon PPT immediate effects: F = 0.15; η2 = 0.02; P > 0.05 and tendon PPT 7-d effects: F = 0.67; η2 = 0.10; P > 0.05). A significant PPT increase in rectus femoris MTrP was found at follow-up in both the HIPE and LIPE groups (both, P < 0.001) with no differences between the groups (immediate effects: F= 1.55; η2 = 0.20; P > 0.05 and 7-d effects: F = 0.71; η2 = 0.10; P > 0.05). Both HIPE and LIPE interventions were considered less painful compared with DN (F = 8.52; η2 = 0.587; P < 0.01).CONCLUSIONHIPE and LIPE induce PPT changes in MTrPs and patellar tendon and improvements in SAKPP, and seem to produce less pain during the intervention compared with DN.

Immediate effects of dry needling on pain sensitivity and pain modulation in patients with chronic idiopathic neck pain: a single-blinded randomized clinical trial

The effects of dry needling and radial extracorporeal shockwave therapy on latent trigger point sensitivity in the quadriceps: A randomised control pilot study