Dry Needling In Patients Research Articles

The effect of combining physiotherapy with dry needling in patients with cervical spondylosis: A randomized controlled trial.

There are no data on the additional contribution of dry needling (DN) for trigger points (TPs) accompanying patients with cervical spondylosis (CS). To analyse the contribution of DN applied to concomitant active TPs in the upper trapezius muscle on the treatment outcomes of physiotherapy in CS. In this prospective randomized controlled study, 70 patients with CS and active TPs in the upper trapezius muscle were included. The first group received physiotherapy for 5 days per week for 3 weeks. The second group received DN with the same program. All participants were evaluated before treatment (day 0) and at the end of treatment (day 21) in terms of pain, functional status, quality of life, anxiety/depression scores, and number of TPs. 33 patients in the first group and 32 patients in the second group completed the study. While the change over time was found significant in all variables, the change was not different between groups. The group-time interaction effect was not found to be statistically significant in any variable. Percentage changes of all variables were similar between the groups. DN treatment added to the physiotherapy did not contribute to recovery in patients with CS.

Pain, function and peritendinous effusion improvement after dry needling in patients with long head of biceps brachii tendinopathy: a single-blind randomized clinical trial

Introduction Long head of biceps brachii tendinopathy, a frequent source of anterior shoulder pain, may lead to discomfort and diminished function. The objective of this study is to assess the efficacy of dry needling and transcutaneous electrical nerve stimulation in these patients. Patients and methods Thirty patients were randomized into dry needling and transcutaneous electrical nerve stimulation groups and assessed before treatment, 8 and 15 days after treatment using a visual analogue scale, shoulder pain and disability index, pressure pain threshold, tissue hardness, and biceps peritendinous effusion. Results Both treatments significantly reduced the visual analogue scale in immediate (p < 0.001), short-term (p < 0.01), and medium-term effects (p < 0.01). Dry needling outperformed transcutaneous electrical nerve stimulation for the pain (p < 0.01) and disability (p < 0.03) subscales of the shoulder pain and disability index in the short-term and medium-term effects, respectively. Pressure pain threshold increased after both treatments but didn’t last beyond 8 days. Neither treatment showed any improvements in tissue hardness of the long head of biceps brachii muscle. Notably, only the dry needling group significantly reduced biceps peritendinous effusion in both short-term and medium-term effects (p < 0.01). Conclusions Dry needling showed non-inferior results to transcutaneous electrical nerve stimulation in reducing pain and disability and demonstrated even superior results in reducing biceps peritendinous effusion (see Graphical ). Trial registration The Institutional Review Board of the China Medical University Hospital (CMUH107-REC2-101) approved this study, and it was registered with Identifier NCT03639454 on ClinicalTrials.gov.

Is adding dry needling to a standard care protocol beneficial in patients with chronic neck pain? A randomized placebo-controlled trial

PurposeTo evaluate the short-term effects of adding a dry needling therapy to a standard care protocol based on education, exercise and electrotherapy, compared to a sham procedure and to a standard care protocol in isolation in patients with chronic neck pain. Material and methodsA randomized placebo-controlled trial was performed. The participants in the dry needling group received a standard care protocol based on patient education, therapeutic exercise and electrotherapy, as well as two sessions of dry needling in the upper trapezius, levator scapulae, and/or sternocleidomastoid muscles. The participants in the sham dry needling group received the same standard care protocol and two sessions of sham dry needling. The participants in the control group received the same standard care protocol. The outcomes measured were pain intensity, pressure pain threshold, neck disability, range of movement, activation of deep cervical flexor muscles, kinesiophobia, pain catastrophizing, anxiety, and depression. ResultsNo significant group by time interactions were found for any of the outcome variables except for lower cervical spine range of movement (F = 3.79; p = 0.030). ConclusionThe addition of two sessions of dry needling in the superficial neck muscles to a standard protocol did not yield superior results compared to either the standard care alone or the standard care plus sham dry needling in patients with chronic neck pain in any outcome except for cervical range of movement.

Effect of Dry Needling in Patient with Cervical Radiculopathy in Reducing Pain and Increasing Rom Compared to Interferential Therapy

Background: This study was designed to inspect the effectiveness of Dry needling and interferential therapy oncervical radiculopathy patients.Purpose: To compare the effectiveness of dry needling and interferential therapy in patients with cervicalradiculopathy.Materials and methods: It is an experimental study from November 2022 to April 2023. In this study, 30 subjectswere allocated randomly using a randomization method (computer-generated random numbers) according toinclusion and exclusion criteria. Group A was allocated for interferential therapy with neck exercise (n=15) andGroup B was allocated for dry needling with neck exercise (n =15). Outcome measures are NPRS (Numerical painrating scale), Goniometer. Informed consent was obtained from the patient.Result: From the statistical analysis, both groups showed extremely satisfied statistical significance between theirpre- and post-test values (p&lt;0.0001) Also, there is a significant difference in the post-test values of both groups(p&lt;0.0001) which denotes that dry needling therapy with neck exercises values are higher than the IFT with neckexercises values for reducing pain and increasing ROM of cervical joint for cervical radiculopathy.Conclusion: In this study, Dry needling with Neck exercise activities was found to be more beneficial than IFTwith neck exercise in reducing cervical pain and increasing ROM.

The Effectiveness of Dry Needling in Patients with Piriformis Syndrome

Background: The research is on assessment of the effectiveness of dry needling in patients with piriformis syndrome.It is a non discogenic form of sciatica brought on by piriformis muscle impingement on the sciatic nerve. It can beresponsible for 0.3% to 6.0% of all sciatica and low back pain cases. Post traumatic piriformis syndrome may occurin patients who experience lumbar nerve-root compression symptoms and signs after receiving a forceful injuryto the buttock. Dry needling is a minimally invasive therapy by the insertion of tiny monofilament needles intomuscles, ligaments, tendons without the use of injectable substances.Purpose: To find the effectiveness of dry needling in patients with piriformis syndrome.Materials and Methods: Total of 356 participants were taken according to the inclusion and exclusion criteriafrom new life phyio, shanthi physio and saravana ortho clinic.The participants were randomly allocated into twogroups, dry needling with theraband exercise group and IFT with theraband exercise group. The group A=178participants and group B=178 participants. All the subjects underwent pretest measurement with NPRS in thebeginning of treatment. The study was quasi experimental study and the duration was about 4 weeks of June 2023.Results: Statistical analysis of data showed significant differences not only in the dry needling group but also inthe conventional group. The dry needling group was significantly higher than the IFT group, with a p value of&lt;0.0001.Conclusion: Dry needling is more effective than IFT in the piriformis syndrome.

Effect of Dry Needling in Patients with Plantar Fasciitis in Reducing Pain Compared to Ultrasound Therapy

Background: Pain and discomfort below the medial calcaneal tubercle especially in the weight-bearing areas arethe hallmarks of plantar fasciitis heel pain. It affects about 10% of people in the general population and affectsabout 83% of active working individuals between the ages of 25 and 65.Purpose: To determine the effect of dry needling therapy on subjects with Plantar fasciitis in reducing pain andincreasing Ankle Range Of Motion (ROM) when compared to Ultrasound therapy with ankle exercises.Materials and Methods: The subjects were selected according to selection criteria. All the subjects were assessedusing Numeric Pain Rating Scale (NPRS) and Ankle ROM. A sample of 50 (45 females and 5 males) was taken forthe study which was further divided into two groups where the experimental group received Dry needling therapywith ankle exercises (n=25) and the control group received Ultrasound therapy with ankle exercises (n=25). Theintervention was given for two weeks. The entire process was performed from November 2022 to April 2023.Result: Statistical analysis showed that there was a significant difference obtained within the groups of pre andpost-test for NPRS and ROM (p&lt;0.0001). A significant difference was obtained between the experimental andcontrol groups for NPRS and ROM (p&lt;0.0001).Conclusion: Dry needling therapy with ankle exercises was more beneficial in reducing pain than ultrasoundtherapy with ankle exercises in Plantar fasciitis subjects.

Effectiveness of dry needling on the treatment of patients with multiple sclerosis: systematic review

Aim: The aim of this study is to review the effectiveness of dry needling in patients with multiple sclerosis (MS). Methods: PubMed, Physiotherapy Evidence Database (PEDro), Web of Science, Scopus, and Cochrane Library databases were searched from its inception until July 2023 and the reference lists of the articles obtained were manually searched. Studies examining the effectiveness of dry needling treatment alone or in combination with a different protocol in individuals diagnosed with MS, regardless of type, were included. The systematic review included quasi-experimental studies and case reports. Studies involving traditional Chinese medicine acupuncture applications, conference abstracts, and protocol records were excluded. Methodological quality assessments were carried out independently by two authors using tools developed by the Joanna Briggs Institute (JBI). Results: A total of 130 studies were found in the searches. Some studies were excluded due to duplication, protocol registration, conference abstract, and content outside the scope of the study and 7 studies were included in the review. In total, 33 individuals were included in this review, 22 of whom were women. Four studies specified the MS type of the patients, while the other studies did not specify MS type. Conclusions: Despite some limitations, this is, to our knowledge, the first review summarizing studies evaluating the effectiveness of dry needling in MS patients. The dry needling technique alone or in a combination of treatments was effective in improving pain, spasticity, range of motion, dexterity, mobility, limb function, and quality of life in MS patients. However, these results should be treated with caution due to the small number of included studies and the lack of randomized controlled trials. Although it is too early to talk about the positive effects of the dry needling technique in MS patients, the study results are promising. More randomized controlled trials should be conducted on this topic.

Immediate Effects of Dry Needling vs. Functional Dry Needling in Patients with Shortened Calf Muscles

Background: Shortened muscle is a condition of physical shortening of the length of the muscle and is also accompanied by other soft tissues surrounding the muscle. In shortened calf muscles the muscles (gastrocnemius and soleus) of lower leg have reduction in their length resulting in pain, reduced range of motion of joint and somehow limiting the functional ability and capability of and individual. The use of dry needling as well as functional dry needling is thought to reduce pain and increase range of motion. Objective: This study was aimed at finding the immediate effects of dry needling versus functional dry needling on pain and range of motion. Methods: It was a quasi-experimental study conducted at Buch International Hospital, Multan &amp; Ali Rehabilitation &amp; pain relief center, Multan from February 01, 2023, to April 31, 2023. There were two groups in total. One group was provided with functional dry needling and the other with dry needling. Only single session was taken and measurements of Numeric Pain Rating Scale and range of motion with goniometry were recorded before and after the treatment. SPSS-27 was used to analyze the data. Results: There were a total of 40 patients. 20 patients were assigned to functional dry needling group and 20 patients to dry needling group. The mean age of patients was 27.65 + 2.368 and 27.80 + 1.852 in functional dry needling and dry needling groups respectively. Pain severity in functional dry needling group reduced significantly compared to dry needling group at the end of the session (p-value=&lt;0.01). Active range of motion and passive range of motion were found non-significant at the end of session (p-value=.089 and p-value=.146) respectively. Conclusion: Both functional dry needling and dry needling reduces pain severity but functional dry needling resulted in reduction in pain severity more than dry needling whereas, both showed non-significant effects on range of motion. Keywords: FDN; functional dry needling, DN; dry needling, AROM; active range of motion, PROM; passive range of motion.

Treadmill exercise post dry needling improves heel rise in patients recovering from surgical ankle fracture: A randomised controlled trial

IntroductionLittle is known about the effectiveness of the dry needling technique (DNT) plus exercise on motor function in musculoskeletal diseases. ObjectiveTo evaluate the effects of treadmill exercise immediately after DNT on pain, range of motion (ROM) and bilateral heel rise test in patients recovering from surgical ankle fracture. MethodA randomised, parallel-group, controlled trial was conducted on patients recovering from surgical ankle fracture. Patients received the DNT intervention for the triceps surae muscle. Then, participants were randomly assigned to the experimental (DNT plus incline treadmill for 20 min) or control group (DNT plus rest for 20 min). Baseline and immediate post-intervention assessments included: visual analogue scale (VAS), maximal ankle dorsiflexion ROM and bilateral heel rise test. ResultsA total of 20 patients recovering from surgical ankle fracture were included. Eleven patients were assigned to the experimental group (mean age 46 ± 12.6 years, 2/9 men/women) and nine to the control group (mean age 52 ± 13.4 years, 2/7 men/women). Two-way ANOVA showed a significant time × group interaction for bilateral heel rise test (F = 5.514, p = 0.030, ηp2 = 0.235). Both groups increased the number of repetitions (p < 0.001), however, the experimental group showed a significant difference compared to control group (mean difference: 2.73 repetitions; p = 0.030). There was no time × group interaction in VAS and ROM (p > 0.05). ConclusionOur results indicate that treadmill exercise after dry needling improves plantar flexors motor function more than rest after dry needling in patients with surgical ankle fracture.

Clinical Effectiveness of Dry Needling in Patients with Musculoskeletal Pain-An Umbrella Review.

The number of systematic reviews (SR) summarizing the literature regarding the clinical effects of Dry Needling (DN) has increased rapidly. Yet, rigorous evidence about the clinical effectiveness of this technique is still lacking. The aim of this umbrella review is to summarize the evidence about the clinical effects of trigger point DN on musculoskeletal disorders across all body regions. PubMed, Web of Science and Embase were searched to identify SRs examining the effect of DN (as a stand-alone intervention or combined with another treatment modality) compared to sham/no intervention or a physical therapy (PT) intervention with at least one clinical outcome in the domain of pain or physical functioning. Risk of bias (RoB) was assessed with the AMSTAR-2 tool. Quantification of the overlap in primary studies was calculated using the corrected covered area (CCA). The electronic search yielded 2286 results, of which 36 SRs were included in this review. Overall, DN is superior to sham/no intervention and equally effective to other interventions for pain reduction at short-term regardless of the body region. Some SRs favored wet needling (WN) over DN for short-term pain reductions. Results on physical functioning outcomes were contradictory across body regions. Limited data is available for mid- and long-term effects. DN has a short-term analgesic effect in all body regions and may be of additional value to the interventions that are used to date in clinical practice. Several studies have shown an additional treatment effect when combining DN to physiotherapeutic interventions compared to these interventions in isolation. There is a substantial need for the standardization of DN protocols to address the problem of heterogeneity and to strengthen the current evidence.

The Effectiveness of Dry Needling in Patients with Hip or Knee Osteoarthritis: A Systematic Review and Meta-Analysis

Background: Osteoarthritis is one of the most common degenerative joint diseases. The main symptoms of the osteoarthritis have been linked to the presence of myofascial trigger points in the soft tissues. Dry needing (DN) is the most investigated technique for the treatment of myofascial trigger points. Thus, the aim of this study was to evaluate the effectiveness of DN in pain and physical function in patients with osteoarthritis in the short-, medium- and long-term. Methods: PubMed, Cochrane Library, PEDro, Web of Science, and SCOPUS databases were searched in September 2022. Randomized controlled trials involving DN compared to non-pharmacological interventions, sham techniques or no additional treatment were selected. Quality of the studies was assessed with PEDro scale and risk of bias with Cochrane Collaboration tool. Meta-analyses were conducted using fixed or random effects models according to the Cochrane handbook for systematic reviews of interventions. Results: Seven studies were included in the meta-analysis involving 291 patients with osteoarthritis. The methodological quality of the included studies ranged from fair to high. DN showed significant improvements in pain intensity (SMD = −0.76; 95% CI: −1.24, −0.29; I2: 74%) and physical function (SMD = −0.98; 95% CI: −1.54, −0.42; I2: 75%) in the short-term. No differences were found in the medium- or long-term. The risk of bias, heterogeneity, and imprecision of the results downgraded the level of evidence to very low. Conclusions: Very low-quality evidence suggests a positive effect of DN for reducing pain intensity and improving physical function in the short term in patients with osteoarthritis. Further investigation is needed to determine a medium- and long-term effects.

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 effectiveness of dry needling in patients with chronic low back pain: a prospective, randomized, single-blinded study

Dry needling (DN) is a standard procedure for treating musculoskeletal disorders. However, there are no clear recommendations for using DN in low back pain (LBP). Therefore, this study aimed to assess the effectiveness of the novel DN program for reducing pain intensity and improving functional efficiency in patients with chronic LBP. A group of 40 patients with chronic LBP due to the L5-S1 discopathy were eligible and randomized into experimental (n = 20) and control (n = 20) groups. The DN program was performed for the experimental group according to the Five Regulatory Systems (FRS) concept. The control group received sham therapy using placebo needles. DN sessions were performed twice a week for 4 weeks. A single needling application lasted 60 min. Both groups received standard treatment and physical exercise of LBP for 1 month. Subjective pain was measured by a visual analog scale (VAS), functional efficiency was assessed with the Oswestry Disability Index (ODI), and the lower spine range of motion was measured with the Schober test. There were significant differences in pain reduction (VAS) in both groups (p < 0.001). The strongest analgesic effect in the DN group yielded 6.45 points immediately after the therapy, 6.2 points after 1 month, and 6 points after 3 months. The DN group scored higher VAS reduction than the control group (p < 0.001). There were significant differences in the functional state (ODI) in the experimental group (p < 0.001). There was a significant ODI decrease by 18.1 points, after 1 month by 18.9 points, and after 3 months by 17.6 points. No significant differences were found in the control group (p > 0.05). Intergroup differences were observed in the functional efficiency in ODI in all measurement time-points (p < 0.001). There were significant differences in the range of motion (Schober test) in the DN group (main effect: p < 0.001). For all measurements, differences (p < 0.001) were observed in favor of DN compared to the control. In conclusion, DN program according to the FRS concept stands for the novel treatment method supplemented by an exercise program, effectively reducing pain and improving functional efficiency in LBP patients.

The potential of physiotherapy technologies in the rehabilitation of patients with non-exudative form of age-related macular degeneration (drusen)

Evaluation of the effectiveness of rehabilitation complex involving physiotherapy in the form of infrared and magnetic stimulation of the retina, aerogenation with Heliox21 and dry needling in patients with non-exudative AMD (drusen). The study included 84 patients (168 eyes), among them 50 men and 74 women with stage 1 non-exudative AMD, aged 60 to 70 years old (average age 60±3.7 years), who were divided into 2 groups with comparable clinical and functional characteristics. Group 1 included 42 patients (84 eyes) who underwent ophthalmic neurostimulation consisting of daily infrared-magnetic stimulation of the retina for 10 days, 10 procedures of daily aerogenation with Heliox21 and 10 daily procedures of acupuncture. Group 2 included 42 patients (84 eyes) who received only basic parenteral therapy (Nutrof forte 1 tablet per day during the entire observation period), which was also the medication background in the main group. Visual acuity (VA), retinal OCT parameters, local photosensitivity and bioelectrical potential indices were assessed with mfERG. The control time points were before therapy, after 2 weeks, 3 months, 6 months and 12 months. After undergoing therapy with the described physiotherapeutic regimen, a positive effect on functional characteristics was noted - the level of light sensitivity of the central zone of the retina and the amplitude of the electrical biopotential have improved. The indicators of maximally corrected visual acuity and the structure of the ellipsoidal zone of the retina and the choroid did not change during the entire observation period. In patients with non-exudative form of AMD the developed ophthalmic rehabilitation complex involving infrared-magnetic stimulation of the retina, aerogenation with Heliox21 and dry needling promotes improvement of functional characteristics of the central retina in the form of increased maximal light sensitivity of the central retinal area and increased amplitude of bio-electrical potential.

Investigation of the Effect of Cervical Spinal Lordosis on the Effectiveness of Dry Needling in Patients with Cervical Myofascial Pain Syndrome

Investigation of the Effect of Cervical Spinal Lordosis on the Effectiveness of Dry Needling in Patients with Cervical Myofascial Pain Syndrome

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.

The Effectiveness of Sternocleidomastoid Muscle Dry Needling in Patients with Cervicogenic Headache.

Background:Cervicogenic headache (CGH) is a secondary headache with a cervical source that radiates pain to the head or face. Accordingly, one reason of CGH is myofascial trigger points. The purpose of this study was to investigate the effect of one session dry needling (DN) of myofascial trigger points of the sternocleidomastoid (SCM) muscle in patients with CGH.Materials and Methods:In this before-and-after clinical trial, 16 females aged 18–60 years with a clinical diagnosis of CGH were enrolled. All of the patients received one session DN into the myofascial trigger points of the SCM muscle. Headache index (HI), headache duration, headache frequency, and headache disability index (HDI) were assessed at 2 weeks before and 2 weeks after the intervention. This study was registered in Clinical Trials as IRCT20181109041599N1.Results:One session DN into myofascial trigger points of the SCM muscle showed a significant improvement in HI (P < 0.001). Duration and frequency of headache as well as HDI significantly reduced after intervention (P < 0.001).Conclusion:One session DN into myofascial trigger points of the SCM muscle was effective on improvement of HI, headache duration, headache frequency, and HDI in patients with CGH.

Spinal manipulation and perineural electrical dry needling in patients with cervicogenic headache: a multicenter randomized clinical trial

BACKGROUND CONTEXTSpinal manipulation, spinal mobilization, and exercise are commonly used in individuals with cervicogenic headache (CH). Dry needling is being increasingly used in the management of CH. However, questions remain about the effectiveness of these therapies and how they compare to each other. PURPOSEThe present study aims to compare the combined effects of spinal manipulation and dry needling with spinal mobilization and exercise on pain and disability in individuals with CH. STUDY DESIGN/SETTINGRandomized, multicenter, parallel-group trial. PATIENT SAMPLEOne hundred forty-two patients (n=142) with CH from 13 outpatient clinics in 10 different states were recruited over a 36-month period. OUTCOME MEASURESThe primary outcome was headache intensity as measured by the Numeric Pain Rating Scale. Secondary outcomes included headache frequency and duration, disability (Neck Disability Index), medication intake, and the Global Rating of Change (GROC). Follow-up assessments were taken at 1 week, 4 weeks, and 3 months. METHODSPatients were randomized to receive upper cervical and upper thoracic spinal manipulation plus electrical dry needling (n=74) or upper cervical and upper thoracic spinal mobilization and exercise (n=68). In addition, the mobilization group also received a program of craniocervical and peri-scapular resistance exercises; whereas, the spinal manipulation group also received up to eight sessions of perineural electrical dry needling. The treatment period for both groups was 4 weeks. The trial was prospectively registered at ClinicalTrials.gov (NCT02373605). Drs Dunning, Butts and Young are faculty within the AAMT Fellowship and teach postgraduate courses in spinal manipulation, spinal mobilization, dry needling, exercise and differential diagnosis. The other authors declare no conflicts of interest. None of the authors received any funding for this study. RESULTSThe 2 × 4 analysis of covariance revealed that individuals with CH who received thrust spinal manipulation and electrical dry needling experienced significantly greater reductions in headache intensity (F=23.464; p<.001), headache frequency (F=13.407; p<.001), and disability (F=10.702; p<.001) than those who received nonthrust mobilization and exercise at a 3-month follow-up. Individuals in the spinal manipulation and electrical dry needling group also experienced shorter duration of headaches (p<.001) at 3 months. Based on the cutoff score of ≥+5 on the GROC, significantly (X2=54.840; p<.001) more patients (n=57, 77%) within the spinal manipulation and electrical dry needling group achieved a successful outcome compared to the mobilization and exercise group (n=10, 15%) at 3-month follow-up. Between-groups effect sizes were large (0.94<standardized mean score difference<1.25) in all outcomes in favor of the spinal manipulation and electrical dry needling group at 3 months. In addition, significantly (X2=29.889; p<.001) more patients in the spinal manipulation and electrical dry needling group (n=49, 66%) completely stopped taking medication for their pain compared to the spinal mobilization and exercise group (n=14, 21%) at 3 months. CONCLUSIONUpper cervical and upper thoracic high-velocity low-amplitude thrust spinal manipulation and electrical dry needling were shown to be more effective than nonthrust mobilization and exercise in patients with CH, and the effects were maintained at 3 months.

Ultrasound-guided Dry Needling in Jumper’s Knee: A Case Report

Abstract Background Jumper’s knee is a highly prevalent tendon condition in volleyball players population. Research on clinical effects of tendon dry needling in jumper’s knee is scarce. Therefore, the aim of this study was to present clinical effects of ultrasound-guided dry needling of quadricipital tendon in a patient with jumper’s knee. Methods A 23-years-old volleyball player, who experienced pain in quadricipital tendon for 5 months, was presented and treated by ultrasound-guided dry needling of quadricipital tendon with one session. Slightly limited knee flexion range of motion, high scores in Visual Analogue Scale (VAS) at rest and during Single-Leg decline Squat test (SLDS) related to high pain intensity, low scores in Victorian Institute of Sport Assessment (VISA-P) scale and Lower Extremity Functional Scale (LEFS) were found. Further examination revealed sensitization of the quadricipital tendon (low pressure pain threshold). Results We found important improvements in VISA-P, LEFS and VAS. Besides, pressure pain threshold and knee flexion during SLDS also showed improvements. Results which were obtained were better in all the variables studied and these recoveries were stable for 6 months. Conclusions Our findings showed improvements in pain and function in medium term and could provide preliminary evidence of beneficial effects of quadricipital tendon dry needling in patients with jumper’s knee. Future studies are needed to clarify our results and compare dry needling with conservative treatments.

Spinal Manipulation and Electrical Dry Needling in Patients With Subacromial Pain Syndrome: A Multicenter Randomized Clinical Trial.

To compare the effects of spinal thrust manipulation and electrical dry needling (TMEDN group) to those of nonthrust peripheral joint/soft tissue mobilization, exercise, and interferential current (NTMEX group) on pain and disability in patients with subacromial pain syndrome (SAPS). Randomized, single-blinded, multicenter parallel-group trial. Patients with SAPS were randomized into the TMEDN group (n = 73) or the NTMEX group (n = 72). Primary outcomes included the Shoulder Pain and Disability Index and the numeric pain-rating scale. Secondary outcomes included the global rating of change scale (GROC) and medication intake. The treatment period was 6 weeks, with follow-ups at 2 weeks, 4 weeks, and 3 months. At 3 months, the TMEDN group experienced greater reductions in shoulder pain and disability (P<.001) compared to the NTMEX group. Effect sizes were large in favor of the TMEDN group. At 3 months, a greater proportion of patients within the TMEDN group achieved a successful outcome (GROC score of 5 or greater) and stopped taking medication (P<.001). Cervicothoracic and upper-rib thrust manipulation combined with electrical dry needling resulted in greater reductions in pain, disability, and medication intake than nonthrust peripheral joint/soft tissue mobilization, exercise, and interferential current in patients with SAPS. The effects were maintained at 3 months. J Orthop Sports Phys Ther 2021;51(2):72-81. Epub 28 Aug 2020. doi:10.2519/jospt.2021.9785.