Deep Dry Needling Research Articles

Evaluation of the effect of dextrose prolotherapy versus deep dry needling therapy for the treatment of temporomandibular joint anterior disc displacement with reduction: (a randomized controlled trial)

Objectiveto compare the combined effect of Prolotherapy and Deep Dry Needling (DDN) versus DDN effect on relieving the symptoms of Temporomandibular joint (TMJ) anterior disc displacement.Patients and methodsThe clinical trial randomly allocated forty patients. The (control group) patients received four intraarticular and masseteric DDN sessions, while the (study group) patients were subjected to the exact technique followed by Prolosolution injection. The baseline preoperative measurements included Maximal interincisal opening (MIO), auscultation of the presence of clicking, and Visual Analogue Scale (VAS), which were repeated for postoperative measurements after one, two, five, and eight months.ResultsBy the end of the study, all patients expressed apparent improvement in pain MIO and clicking. The inter- and intragroup comparison revealed that the pain score values of the control group after five and eight months were significantly higher than those of the study group. The study group demonstrated more significant MIO calibration than the control group, with insignificant differences between both groups regarding the presence of clicking at any time interval. The associations between clicking and VAS values, between clicking and MIO, and between VAS values and increased MIO were positive in the test group and negative in the control group.ConclusionsDextrose Prolotherapy and DDN were beneficial. However, Prolotherapy demonstrated more significant, sustained, and correlated long-term alleviation of symptoms and increased MIO.Clinical relevanceThe study assesses the sole effect of dextrose prolotherapy on relieving the signs of TMJ anterior disc displacement apart from the impact of the penetrating needle.Clinical trial registrationThe study was registered on www.clinicaltrials.gov (#: NCT05821985) by Ahmed Nagi Alghandour.

Unraveling the Mechanisms Behind the Short-Term Effects of Dry Needling: New Insights From a Mediation Analysis With Repeatedly Measured Mediators and Outcomes

ObjectiveTo explore the causal pathways underlying the short-term effects of deep dry needling (DDN) in people with chronic neck pain. DesignExplanatory longitudinal mediation analysis with repeatedly measured mediators and outcomes. SettingPrimary care setting. ParticipantsPatients (N=128) with chronic neck pain. InterventionsParticipants were randomized into 2 groups; DDN of the neck muscles combined with stretching (n=64) and stretching alone (n=64). Main Outcome MeasuresTwo outcomes (pain intensity and neck pain–related disability) and 3 candidate mediators (local pressure pain thresholds [PPTs], cervical range of motion [ROM], and neck muscle strength) were included. Pain intensity was also included as a competing mediator in the mediation analysis for disability. Mediators and outcomes were measured at 3 time points: after intervention and at 2- and 4-week follow-up. Age, sex, and the baseline values of the outcome and mediators were included as pretreatment mediator-outcome confounders. ResultsReductions in pain intensity strongly mediated the short-term effects of DDN on disability, from after intervention to 4-week follow-up. In addition, the attenuation of local hypersensitivity (via increasing PPTs) moderately mediated reductions in pain intensity at each time point. On the other hand, gains in cervical ROM contributed to reducing neck pain–related disability. Changes in muscle strength did not lead to better outcomes. ConclusionsThis novel study demonstrated that DDN effect on neck pain–related disability is strongly driven by the analgesic effects of this physical therapy modality. Increasing PPTs and cervical ROM seem to be also part of the mechanisms behind DDN's effect.

Effect of Mirror Therapy on Post-Needling Pain Following Deep Dry Needling of Myofascial Trigger Point in Lateral Elbow Pain: Prospective Controlled Pilot Trial.

Background: This prospective randomized, controlled pilot trial to explore the immediate effect of adding Mirror Visual Feedback Therapy on pain sensitivity and motor performance among subjects suffering from post-needling pain diagnosed as Lateral Elbow Pain. Methods: A total of 49 participants (23 female, 26 male) were enrolled and randomly allocated to either the experimental group, which received Deep Dry Needling in the m. Brachioradialis, Ischemic Compression, Cold Spray, Stretching, and Mirror Visual Feedback Therapy (n = 25), or a control group without Mirror Visual Feedback Therapy (n = 24). Pre- and post-treatment evaluations included assessments of post-needling pain intensity, pressure pain threshold, two-point discrimination threshold, and maximum hand grip strength. Results: Intergroup analysis revealed a statistically significant reduction in post-needling pain intensity favoring the experimental group (U = 188.00, p = 0.034). Additionally, intragroup analysis showed significant improvements in post-needling pain intensity (MD = 0.400, SEM = 0.271, W = 137.00, p = 0.047) and pressure pain threshold (MD = 0.148 Kg/cm2, SEM = 0.038, W = 262.00, p < 0.001) within the experimental group following the intervention. Conclusions: These findings suggest a potential benefit of integrating Mirror Visual Feedback Therapy into treatment protocols for individuals with Lateral Elbow Pain experiencing post-needling discomfort. Further research is necessary to fully elucidate the clinical implications of these findings.

Deep dry needling versus muscle energy technique on pain and functional disability in chronic nonspecific neck pain.

Deep dry needling versus muscle energy technique on pain and functional disability in chronic nonspecific neck pain.

Acute Effects of Dry Needling on Lower Limb Muscle Strength in CrossFit Athletes with Latent Trigger Points: A Randomized Triple-Blinded Pilot Clinical Trial

Study purpose. The purpose of this study was to evaluate the acute effect of deep dry needling (DP) on lower-limb muscle strength-related variables in CrossTraining recreational athletes with latent trigger point (TrP). Materials and methods. A total of 19 healthy CrossFit®-trained males (27.8 [4.7] years; 79.8 [10.4] kg; 1.76 [0.07] cm) with myofascial TrP in quadriceps, gluteus or gastrocnemius muscles completed this repeated-measures triple-blind pilot clinical trial. Participants were randomly allocated into either experimental (EG, n = 10) or Sham (SG, n = 9) groups. After allocation, the assessment of lower-limb muscle power (squat jump [SJ] and countermovement jump [CMJ]) and maximal isometric hip abduction and quadriceps strength were measured at baseline and after 48 hours of the intervention. Results. The results are expressed as Δ (SD) [95% CI]; unbiased Cohen’s d [dunb, 95% CI]). DN has been shown to reduce the presence of muscle TrP. The maximal isometric hip abduction strength had a moderate-to-high significant increase in the EG (left: 21.5 (16.9) [9.42, 33.57]; 0.55 [0.19, 0.99], right: 20.3 (16.2) [8.70, 31.89]; 0.74 [0.25, 1.35]); however, the Sham group only showed significant improvement in the left hip abductor muscles 15.77 (15.37) [3.96, 27.59]; 0.57 [0.11, 1.12]) with no significant changes in the right side. Conclusions. The acute reduction of myofascial TrP was observed with the application of DN but had no significant effect on maximal isometric strength or jump height compared to the Sham group. Results of this pilot clinical trial can be used to commission future research.

The Effect of Knee Joint Muscles Deep Dry Needling on Pain and Function in Patients After Total Knee Arthroplasty

Objective Osteoarthritis is one of the most common knee joint diseases. It is a multifactorial, inflammatory, and destructive disorder of the joint that involves the synovial tissues and joint cartilage and causes permanent pain, functional limitations, and a decrease in patients’ quality of life (QoL). In advanced cases of the disease, total knee arthroplasty is performed to reduce pain and improve the function of the patients. The presence of pain after this surgery is a major concern that reduces the QoL of these people. One of the causes of pain after surgery is extra-articular pain and involvement of the musculoskeletal system, the most common cause of which is pain caused by active trigger points. Dry needling is one way to deactivate trigger points. This study aimed to investigate the effects of dry needling on the pain intensity and function of patients with active trigger points in the muscles around the knee after total knee arthroplasty. Materials &amp; Methods This research was a before-and-after clinical trial study. In this study, 49 patients aged 55 to 80 years, with at least 3 months past their total knee arthroplasty and still having pain, were included by an orthopedic specialist after reviewing the inclusion and exclusion criteria. After the first researcher considered the inclusion and exclusion criteria and the presence of active trigger points in the muscles around the knee, including the quadriceps, hamstring, and gastrocsoleus, 27 patients were qualified. The amount of pain in these patients before, one week, and one month, after dry needling was measured and compared based on the linear visual analog scale. Also, the performance of the patients was assessed based on the knee injury and osteoarthritis outcome score questionnaire. This study aimed to investigate the short-term effects of dry needling on pain intensity and function of patients with active trigger points in the muscles around the knee after total knee arthroplasty. Results The results of this study show a significant difference (P&lt;0.001) between the amount of pain before dry needling (57.2±8.9) and one week after dry needling (10.8±33.6). Also, there is a significant (P&lt;0.006) difference between the performance of patients before dry needling (47.5±11.9) and one week after dry needling (42.3±10.6). No significant difference was observed regarding pain and performance between one week and one month after dry needling. Conclusion Performing one dry needling session on the active trigger points of the muscles around the knee after total knee arthroplasty reduces pain and improves patients’ performance.

Efficacy of Deep Dry Needling versus Percutaneous Electrolysis in Ultrasound-Guided Treatment of Active Myofascial Trigger Points of the Levator Scapulae in Short-Term: A Randomized Controlled Trial.

Deep dry needling (DDN) and percutaneous electrolysis (PE) provide the benefit of the mechanical effect of the needle, and PE adds the potential advantages of the galvanic current it incorporates in myofascial trigger points (MTrPs) therapy. The aim of this study was to compare the short-term efficacy between PE and DDN on active MTrPs of the levator scapulae by considering pain intensity. A simple-blind randomized controlled trial was carried out, recruiting patients suffering from non-specific neck pain lasting more than 3 months and with active MTrPs in the levator scapulae muscle (n = 52). Patients were divided into intervention (PE; n = 26) and control (DDN; n = 26) groups and received one treatment session on the active MTrPs of the levator scapulae. Patients were assessed for pain intensity, pressure pain threshold (PPT), cervical range of motion (CROM), neck disability and post-needling soreness, immediately after treatment, at 72 h and at 14 days. In addition, pain during treatment was recorded after the procedure. There were no significant differences for pain intensity, post-needling soreness and PPT. We found significant differences in CROM, immediately after treatment (p = 0.043), and at 72 h (p = 0.045), in favor of the PE group. Significant differences were found for neck disability (p < 0.047), immediately post-treatment, in favor of the DDN group. Moreover, there were significant differences for pain during the intervention (p < 0.002), in favor of the DDN group (4.54 ± 2.21) versus the PE group (6.54 ± 2.27). PE and DDN appear to have similar short-term effects. PE proved to be a more painful treatment than DDN. Clinical trial registry: NCT04157426.

Comparison of immediate and delayed effects of superficial and deep dry needling in patients with upper trapezius myofascial trigger points

BackgroundDry needling is one of the most common treatments for this condition. In this study the immediate and delayed effects of superficial dry needling (SDN) and deep dry needling (DDN) on upper trapezius muscle function and patients' pain and disability was evaluated. MethodsIn this quasi-experimental study, 47 women with active MTrPs were randomly divided into SDN and DDN groups and received one session treatment. Pain and disability were assessed before and one week after intervention with visual analogue scale (VAS) and neck disability index (NDI) questionnaire. Muscle activity was assessed by surface electromyography (sEMG) before, immediately and one week after intervention. ResultsBoth groups showed significant decrease in VAS (p < 0.001) and NDI (p < 0.001) after one week, however no significant difference were found between the groups (p > 0.05). A significant increase in sEMG activity was observed only in DDN group after one week (p < 0.007), but there were no significant differences in sEMG activity in SDN group after intervention and between the two groups (p > 0.05). ConclusionBoth SDN and DDN could be effective in reducing pain and disability in patients with active MTrPs of upper trapezius muscle. Regarding muscle function DDN seems to be more effective. So that based on evaluation of the therapist in some cases with not significant muscle dysfunction SDN as a gentle and less invasive method could be used but for long term effectiveness and in those with significant muscle dysfunction DDN could be used.

The Application of Image Texture Analysis Techniques on the Effects of Dry Needling versus Placebo in Low-Back Pain Patients: A Pilot-Study

Low back pain is the leading cause of disability in the world, with a significant socio-economic impact. Deep dry needling is effective in the treatment of this pain, and it is one of the techniques preferred by physiotherapists. In this field, the use of ultrasound provides information of interest such as length, thickness, diameter, cross-sectional area, or muscle volume, among others. Objective: To find out whether the tissue changes (thickness, histogram, and contraction rate) that occur in the lumbar multifidus after application of the deep dry needle are related to changes in the pain and the disability of the patient. Design: Randomized, double-blind, parallel-group clinical trial. Setting: University of Alcalá, Department of Physiotherapy. Subjects: 21 voluntary patients (women and men) with non-specific low-back pain aged 18–65 years. Intervention: Patients were randomly divided into two groups. One group received dry needling and the other group a dry needling placebo. Initial post-needling and one week post-needling assessments were performed by a therapist blinded to the intervention. Variables: Lumbar multifidus thickness measured by RUSI, contraction time measured by M-mode, histograms measured by image analysis, muscle area, pain measured by VAS, pressure pain threshold measured by pressure algometer, and disability measured by Roland–Morris questionnaire. Conclusions: The contraction speed, resting thickness, and pain demonstrated significant differences within each group, but not between groups. There were significant differences in contraction ratio and in PPT between groups. There was excellent intra-examiner reliability in image collection for histogram analysis. Histogram analysis showed no significant differences between groups and measurements, neither for the parameters nor for the parameters combined with the outcome variables. A robust method for the image texture analyses in future histogram muscle analyses has been performed.

Effect of Deep Dry Needling on Spasticity in Traumatic Brain Injury

Effect of Deep Dry Needling on Spasticity in Traumatic Brain Injury

Dry needling in active or latent trigger point in patients with neck pain: a randomized clinical trial

The purpose was to determine the efficacy of deep dry needling (DDN) applied on an active myofascial trigger point (MTrP) versus a latent-MTrP versus a non-MTrP location, on pain reduction and cervical disability, in patients with chronic neck pain. A randomized, double-blind clinical trial design was used. A sample of 65 patients was divided into non-MTrP-DDN, active-MTrP-DDN and latent-MTrP-DDN groups. The visual analog scale (VAS), reproduction of the patient’s pain, number of local twitch responses, pressure pain threshold (PPT) and Neck Disability Index (NDI) were assessed before, during and after the intervention and up to 1 month post-intervention. The active-MTrP-DDN-group reduced pain intensity more than non-MTrP-DDN-group after a week and a month (P < 0.01), as well as showing the greatest improvement in tibialis muscle PPT. The treatment of both Active and Latent MTrPs was associated with the reproduction of the patient’s pain. The application of DDN on an active-MTrP in the upper trapezius muscle shows greater improvements in pain intensity after 1 week and 1 month post-intervention, compared to DDN applied in latent-MTrPs or outside of MTrPs in patients with neck pain.

Evaluation of the Effectiveness of Dry Needling in the Treatment of Myogenous Temporomandibular Joint Disorders.

Background and Objectives: The objective of our clinical trial was to determine the effectiveness of the deep dry needling technique (DDN) (neuromuscular deprogramming) as a first step in the treatment of temporomandibular disorders. Methods and Materials: The double-blind randomized clinical trial comprised 36 patients meeting the inclusion criteria who had signed the corresponding informed consent form. The participants were randomly distributed into two groups, the Experimental group (Group E) and the Control group (Group C). Group E received bilateral DDN on the masseter muscle, while Group C received a simulation of the technique (PN). All the participants were evaluated three times: pre-needling, 10 min post-needling, and through a follow-up evaluation after 15 days. These evaluations included, among other tests: pain evaluation using the Visual Analog Scale (VAS) and bilateral muscle palpation with a pressure algometer; evaluation of the opening pattern and range of the mouth, articular sounds and dental occlusion using T-scans; and electromyography, which was used to evaluate the muscle tone of the masseter muscles, in order to control changes in mandibular position. Results: Digital control of occlusion using Tec-Scan (digital occlusion analysis) showed a significant reduction both in the time of posterior disclusion and in the time needed to reach maximum force in an MI position after needling the muscle, which demonstrated that there were variations in the static position and the trajectory of the jaw. The symmetry of the arch while opening and closing the mouth was recovered in a centric relation, with an increase in the opening range of the mouth after the procedure. Conclusions: facial pain is significantly reduced and is accompanied by a notable reduction in muscle activity after needling its trigger points.

Acute and Short-Term Effects of Dry Needling in Patients with Chronic Nonspecific Low Back Pain and Hamstring Tightness: A Pilot Study.

Background Chronic nonspecific low back pain (LBP) is one of the common health issues. Hamstring tightness contributes to the development of LBP. This study aimed to investigate the acute and short-term effects of deep dry needling (DN) in patients with chronic nonspecific LBP and hamstring muscle tightness. Methods A single-group pretest-posttest clinical study design was followed. The outcome measures were the visual analog scale (VAS), passive knee extension (PKE) test, finger-floor distance (FFD) test, and functional rating index (FRI). Patients underwent one session of deep DN of three points on both hamstring muscles, each point for one minute. Patients were assessed before (T0), immediately after (T1), and one week after DN (T2). The FRI was assessed at T0 and T2. Results Ten women with a mean age of 21.1 years (SD = 1.6) participated in the study. Significant large effect sizes in VAS pain reduction (d = 1.25) and PKE hamstring tightness were obtained (hamstring: right, d = 0.82; left, d = 0.88) at T2. Medium effect sizes were obtained for FFD (d = 0.45) and FRI (d = 0.72) at T2. Conclusion A single session of deep DN improved pain and function and increased hamstring flexibility. This pilot study supports the use of DN in patients with LBP and hamstring tightness; however, future research with a rigorous study design of randomized controlled trial is required to confirm the findings. This trial is registered with IRCT20180511039612N1.

Effects of Dry Needling on Spinal Reciprocal Inhibition

<h3>Research Objectives</h3> Spinal reciprocal inhibition is an important spinal mechanism of motor control. It is often impaired in persons after stroke, negatively impacting locomotion; at the same time, it changes in response to therapeutic interventions (e.g., FES). An increasing number of physical therapists worldwide have been administering trigger point deep dry needling (DDN) to treat post-stroke spasticity. Yet, currently, effects of DDN on spinal somatosensory processing are not well understood. Thus, to understand neurophysiological mechanisms of DDN, we are investigating the effects of DDN on spinal pathways in persons with and without stroke. <h3>Design</h3> Before and 0, 90 minutes, and 72 hours after DDN of the medial gastrocnemius (MG) at myofascial trigger points, reciprocal inhibition of the soleus, MG and lateral gastrocnemius (LG) was examined while the participant stood and maintained his/her standing posture and triceps muscle activity. Passive ankle range of motion (ROM) was also measured before and after DDN. <h3>Setting</h3> University. <h3>Participants</h3> 11 adults 22-57 years old (median 37.5) without known neurological conditions. <h3>Interventions</h3> Trigger point dry needling to medial gastrocnemius <h3>Main Outcome Measures</h3> Reciprocal inhibition of ongoing muscle activity elicited by common peroneal nerve (CPN) stimulation. ROM. <h3>Results</h3> In the MG and LG, there was no systematic changes in the amount of inhibition across participants or measurement times. Soleus inhibition elicited by suprathreshold CPN stimulation was increased significantly at 0 minute and 72 hours post DDN (p>0.05). Ankle dorsiflexion ROM was increased by 4 deg at 0 minutes and 72 hours post DDN. <h3>Conclusions</h3> DDN alters soleus inhibition, which may partially explain increased ankle ROM post DDN. In order to understand how DDN affects reciprocal inhibition in the stroke-impaired CNS, studies of individuals after stroke are currently underway. <h3>Author(s) Disclosures</h3> The authors have no conflicts of interest to declare.

Effects of Dry Needling on Spinal Reflexes: The Hoffman-reflex

<h3>Research Objectives</h3> Spasticity can lead to changes in spinal and supraspinal pathways which can lead to decreased function and quality of life in persons with stroke. Physical therapists worldwide have been administering trigger point deep dry needling (DDN) to treat post-stroke spasticity. Yet, currently, effects of DDN on spinal somatosensory processing are not well understood. To understand the neurophysiological mechanisms of DDN, we are currently investigating the effects of DDN on spinal somatosensory pathways in persons with and without stroke. <h3>Design</h3> Before, 0 minutes, 90 minutes, and 72 hours after DDN of the medial gastrocnemius (MG) the H-reflex and M-wave recruitment curves are measured in the soleus, MG and lateral gastrocnemius (LG). Passive ankle range of motion (ROM) before and after DDN. <h3>Setting</h3> University. <h3>Participants</h3> 11 adults 22-57 years old (median 37.5) without known neurological conditions. <h3>Interventions</h3> Trigger point dry needling to medial gastrocnemius. <h3>Main Outcome Measures</h3> H-Reflex and ROM. <h3>Results</h3> MG H-reflex latency was prolonged by 1-3 ms at 0- and 90-minutes post (in 9/11 individuals) and in 5/11 in the soleus and 3/11 in the LG. In the MG, H-reflex amplitude was significantly decreased at 72 hours post (p=0.004 by paired t-test) by 12%. Dorsiflexion ROM was increased by »4 deg at 0 minutes and 72 hours post. <h3>Conclusions</h3> DDN produces acute short-term effects (shown in the H-reflex latency shift at 0- and 90-minutes post) and significant long-term effects (shown in the reduced H-reflex at 72 hours post) in spinal pathways of the treated MG. To understand whether DDN affects the intact CNS and stroke-impaired CNS similarly or differently, studies of individuals after stroke are currently underway. <h3>Author(s) Disclosures</h3> The authors have no conflicts of interest to declare.

Analysis and comparison of pain pressure threshold and active cervical range of motion after superficial and deep dry needling techniques of the upper trapezius muscle.

To evaluate the changes in pain pressure threshold (PPT) and active cervical range of motion (ACROM) after the application of superficial dry needling (DN) or deep DN in myofascial trigger point (MTrP) 1 of the upper trapezius versus a simulated DN technique in the gastrocnemius muscle (control group). Double-blind, randomized controlled trial with 7-day follow-up. Asymptomatic volunteers (n = 180; 76 men, 104 women) with a latent MTrP 1 in the upper trapezius were randomly divided into three groups: G1, receiving superficial DN in the upper trapezius; G2, receiving deep DN in the upper trapezius; and G3, control group, receiving simulated DN technique in the gastrocnemius muscle. While sitting in a chair, each subject underwent measurements of PPT and ACROM (ipsilateral and contralateral side flexion and rotation, flexion and extension) preintervention, (immediately) postintervention, and at 24 h, 72 h and 7 days. Superficial and deep DN produced an increase in PPT at 7 days with respect to preintervention levels. Furthermore, superficial and deep DN produced a decrease in cervical flexion at 24 h and an increase in ipsilateral rotation until 72 h, increasing to 7 days in the case of deep DN. On the contrary, superficial DN produced an increase in ipsilateral and contralateral side flexion after intervention, unlike deep DN that produced a decrease at 24 h. Furthermore, superficial DN produced an increase in contralateral rotation at 24 h and deep DN decreased extension at 72 h. A single intervention of superficial or deep DN did not produce statistically significant changes in PPT or goniometry measurements.Trial registration number: NCT03719352 (ClinicalTrials.gov).

Electromyographic Assessment of the Efficacy of Deep Dry Needling versus the Ischemic Compression Technique in Gastrocnemius of Medium-Distance Triathletes.

Several studies have shown that gastrocnemius is frequently injured in triathletes. The causes of these injuries are similar to those that cause the appearance of the myofascial pain syndrome (MPS). The ischemic compression technique (ICT) and deep dry needling (DDN) are considered two of the main MPS treatment methods in latent myofascial trigger points (MTrPs). In this study superficial electromyographic (EMG) activity in lateral and medial gastrocnemius of triathletes with latent MTrPs was measured before and immediately after either DDN or ICT treatment. Taking into account superficial EMG activity of lateral and medial gastrocnemius, the immediate effectiveness in latent MTrPs of both DDN and ICT was compared. A total of 34 triathletes was randomly divided in two groups. The first and second groups (n = 17 in each group) underwent only one session of DDN and ICT, respectively. EMG measurement of gastrocnemius was assessed before and immediately after treatment. Statistically significant differences (p = 0.037) were shown for a reduction of superficial EMG measurements differences (%) of the experimental group (DDN) with respect to the intervention group (ICT) at a speed of 1 m/s immediately after both interventions, although not at speeds of 1.5 m/s or 2.5 m/s. A statistically significant linear regression prediction model was shown for EMG outcome measurement differences at V1 (speed of 1 m/s) which was only predicted for the treatment group (R2 = 0.129; β = 8.054; F = 4.734; p = 0.037) showing a reduction of this difference under DDN treatment. DDN administration requires experience and excellent anatomical knowledge. According to our findings immediately after treatment of latent MTrPs, DDN could be advisable for triathletes who train at a speed lower than 1 m/s, while ICT could be a more advisable technique than DDN for training or competitions at speeds greater than 1.5 m/s.

The Influence of Verbal Suggestion on Post-Needling Soreness and Pain Processing after Dry Needling Treatment: An Experimental Study.

Background: It remains unclear as to whether verbal suggestions and expectancies can influence the perception of post-needling soreness. The aim of this study was to analyze the effects of verbal suggestions on post-needling soreness after dry needling of the trapezius muscle. Methods: This study is a randomized controlled trial including healthy subjects randomly assigned to one of three groups receiving different verbal suggestions about the effects of dry needling and the occurrence of post needling soreness (positive, negative, or neutral). Then, dry needling on a latent trigger point of the upper trapezius muscle was performed and the following outcomes were measured immediately after, 24, 48, and 72 h, and one week after the intervention: post-needling soreness intensity, pressure pain threshold (PPT), temporal summation (TS) and conditioned pain modulation (CPM). Results: Seventy-three consecutive participants were screened and 42 participants (12 men and 30 women, aged: 24 ± 8 years old) were eligible and finished the study protocol. The results showed that verbal suggestion did not influence the perception of post-needling soreness, since there were no differences between groups (p < 0.05) on the intensity of post-needling soreness or tenderness over a one-week follow-up. Moreover, verbal suggestion did not associate with changes in sensorimotor variables of TS and CPM. Conclusions: The induction of different types of expectations through verbal suggestion does not influence the perception of acute pain perceived during the performance of a deep dry needling technique and post-needling pain or soreness after deep dry needling on a latent upper trapezius myofascial trigger point (MTrP).

Effectiveness of Dry Needling with Percutaneous Electrical Nerve Stimulation of High Frequency Versus Low Frequency in Patients with Myofascial Neck Pain

Percutaneous nerve electrical stimulation is a novel treatment modality for the management of acute and chronic myofascial pain syndrome. To compare the effectiveness of dry needling combined with percutaneous electrical nerve stimulation of low frequency versus high frequency, in patients with chronic myofascial neck pain. Randomized, single-blind trial. Laboratory in an academic institution. A total of 40 volunteer patients with chronic neck pain were randomly divided into 2 groups. All patients initially received deep dry needling in a myofascial trigger point of the upper trapezius. Then, one group received high frequency percutaneous electrical nerve stimulation while the other group received low frequency percutaneous electrical nerve stimulation. The primary outcomes were the visual analog scale and the pressure pain threshold, while Neck Disability Index and Kinesiophobia were secondary outcomes. We detected significant improvements in the visual analog scale score in both groups without differences between them. We did not observe significantly different statistics in either group during the evaluation of data on pressure pain threshold. Limitations of the study include (1) heterogeneity of the sample in relation to gender, with more women, (2) the small sample size (40 patients), (3) the absence of placebo group, and (4) the fact that the treatment is focused exclusively on the upper trapezium myofascial trigger point. . Low and high frequency percutaneous electrical nerve stimulation combined with deep dry needling showed similar effects, since no differences between groups were observed on any of the outcome measures. High and low frequency of percutaneous electrical nerve stimulation generates changes on pain intensity and disability, but not on pressure pain threshold or fear of movement.

Effects of deep friction massage and dry needling therapy on night pain and shoulder internal rotation in subacromial pain syndrome: 1-year follow up of a randomised controlled trial

Background/AimsShoulder problems are common in the general population. The aim of this research was to compare the short and long-term effects of trigger point deep friction massage and trigger point dry needling therapy on rest, activity, and the intensity of night shoulder pain and shoulder internal rotation in Subacromial Pain Syndrome.MethodsOut of 73 outpatients diagnosed with Subacromial Pain Syndrome, 40 were selected according to agreed criteria and were randomly assigned to two groups. A total of 19 patients received trigger point deep friction massage and 21 received trigger point dry needling therapy. The trigger point deep friction massage group received treatment over 3 weeks and the trigger point dry needling therapy group received treatments over 4 weeks. Both groups received six treatment sessions and a programme of post-treatment exercises. The shoulder internal rotation angle was measured using a goniometer, and pain intensities were measured using a visual analogue scale before the first session, after six sessions and after 1 year.ResultsAccording to both the short- and long-term data, significant improvements were seen in both groups for all parameters. However, when the groups were compared, no significant difference was found between the two interventions, although the trigger point deep friction massage intervention showed earlier improvements as the treatments could be carried out in 3 weeks, rather than the 4 weeks required for the trigger point dry needling therapy sessions.ConclusionsBoth trigger point deep friction massage and trigger point dry needling therapy are effective in improving pain and shoulder internal rotation. Both groups maintained significant clinical improvement throughout the year. Although both interventions produced good results, trigger point deep friction massage treatments were completed in a shorter time and so demonstrated earlier improvements. Therefore, Trigger point deep friction massage may be regarded as the preferred option, particularly as no equipment is needed and is a non-invasive method of treatment.