Efficacy of Dry Needling Versus Transcutaneous Electrical Nerve Stimulation in Patients With Neck Pain Due to Myofascial Trigger Points: A Randomized Controlled Trial (original) (raw)
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Journal of Clinical Medicine
Our aim was to evaluate the effect of dry needling alone as compared to sham needling, no intervention, or other physical interventions applied over trigger points (TrPs) related with neck pain symptoms. Randomized controlled trials including one group receiving dry needling for TrPs associated with neck pain were identified in electronic databases. Outcomes included pain intensity, pain-related disability, pressure pain thresholds, and cervical range of motion. The Cochrane risk of bias tool and the Physiotherapy Evidence Database (PEDro) score were used to assessed risk of bias (RoB) and methodological quality of the trials. The quality of evidence was assessed by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Between-groups mean differences (MD) and standardized mean differences (SMD) were calculated (3) Twenty-eight trials were finally included. Dry needling reduced pain immediately after (MD −1.53, 95% CI −2.29 to −0.76) and at sh...
Pain Research and Management, 2021
Objective. To evaluate the effects of combining dry needling with other physical therapy interventions versus the application of the other interventions or dry needling alone applied over trigger points (TrPs) associated to neck pain. Databases and Data Treatment. Electronic databases were searched for randomized controlled trials where at least one group received dry needling combined with other interventions for TrPs associated with neck pain. Outcomes included pain intensity, pain-related disability, pressure pain thresholds, and cervical range of motion. The risk of bias (RoB) was assessed using the Cochrane risk of bias tool, methodological quality was assessed with PEDro score, and the quality of evidence was assessed by using the GRADE approach. Between-groups mean differences (MD) and standardized mean difference (SMD) were calculated. Results. Eight trials were included. Dry needling combined with other interventions reduced pain intensity at short-term (SMD −1.46, 95% CI −...
Pain, 2016
Chronic neck pain attributed to a myofascial pain syndrome is characterized by the presence of muscle contractures referred to as myofascial trigger points. In this randomized, parallel-group, blinded, controlled clinical trial, we examined the effectiveness of deep dry needling (DDN) of myofascial trigger points in people with chronic nonspecific neck pain. The study was conducted at a public Primary Health Care Centre in Madrid, Spain, from January 2010 to December 2014. A total of 130 participants with nonspecific neck pain presenting with active myofascial trigger points in their cervical muscles were included. These participants were randomly allocated to receive: DDN plus stretching (n 5 65) or stretching only (control group [n 5 65]). Four sessions of treatment were applied over 2 weeks with a 6-month follow-up after treatment. Pain intensity, mechanical hyperalgesia, neck active range of motion, neck muscle strength, and perceived neck disability were measured at baseline, after 2 sessions of intervention, after the intervention period, and 15, 30, 90, and 180 days after the intervention. Significant and clinically relevant differences were found in favour of dry needling in all the outcomes (all P , 0.001) at both short and long follow-ups. Deep dry needling and passive stretching is more effective than passive stretching alone in people with nonspecific neck pain. The results support the use of DDN in the management of myofascial pain syndrome in people with chronic nonspecific neck pain.
Pain Research and Treatment, 2015
The aim of this study was to compare the efficacy of three interventions for the treatment of myofascial chronic neck pain. Methods. Thirty-six patients were randomly assigned to one of three intervention groups: orthopedic manual therapy (OMT), dry needling and stretching (DN-S), and soft tissue techniques (STT). All groups received two treatment sessions with a 48 h time interval. Outcome measures included neck pain intensity measured using a visual analogue scale, cervical range of motion (ROM), pressure pain threshold for measuring mechanical hyperalgesia, and two self-reported questionnaires (neck disability index and pain catastrophizing scale). Results. The ANOVA revealed significant differences for the group × time interaction for neck disability, neck pain intensity, and pain catastrophizing. The DN-S and OMT groups reduced neck disability. Only the OMT group showed decreases in mechanical hyperalgesia and pain catastrophizing. The cervical ROM increased in OMT (i.e., flexion, side-bending, and rotation) and DN-S (i.e., side-bending and rotation) groups. Conclusions. The three interventions are all effective in reducing pain intensity. Reduction in mechanical hyperalgesia and pain catastrophizing was only observed in the OMT group. Cervical ROM improved in the DN-S and OMT groups and also neck disability being only clinically relevant for OMT group.
2015
Objective: To determine whether dry needling of an active myofascial trigger point (MTrP) reduces pain and alters the status of the trigger point to either a nonespontaneously tender nodule or its resolution. Design: A prospective, nonrandomized, controlled, interventional clinical study. Setting: University campus. Participants: A total of 56 subjects with neck or shoulder girdle pain of more than 3 months duration and active MTrPs were recruited from a campus-wide volunteer sample. Of these, 52 completed the study (23 male and 33 female). Their mean age was 35.8 years. Interventions: Three weekly dry needling treatments of a single active MTrP. Main Outcome Measures: Primary Outcomes: Baseline and posttreatment evaluations of pain using a verbal analogue scale, the Brief Pain Inventory, and the status of the MTrP as determined by digital palpation. Trigger points were rated as active (spontaneously painful), latent (requiring palpation to reproduce the characteristic pain), or resolved (no palpable nodule). Secondary Outcomes: Profile of Mood States, Oswestry Disability Index, and Short Form 36 scores, and cervical range of motion. Results: Primary outcomes: A total of 41 subjects had a change in trigger point status from active to latent or resolved, and 11 subjects had no change (P < .001). Reduction in all pain scores was significant (P < .001). Secondary outcomes: Significant improvement in posttreatment cervical rotational asymmetry in subjects as follows: unilateral/bilateral MTrPs (P ¼ .001 and P ¼ 21, respectively); in pain pressure threshold in subjects with unilateral/bilateral MTrPs, (P ¼ .006 and P ¼ .012, respectively); improvement in the SF-36 mental health and physical functioning subscale scores (P ¼ .019 and P ¼ .03), respectively; and a decrease in the Oswestry Disability Index score (P ¼ .003). Conclusions: Dry needling reduces pain and changes MTrP status. Change in trigger point status is associated with a statistically and clinically significant reduction in pain. Reduction of pain is associated with improved mood, function, and level of disability.
2018
Background: Few studies have compared superficial and deep dry needling techniques in treatment of trigger points in patients with Myofascial Pain Syndrome (MPS). Objectives: To compare the effects of Superficial Dry Needling (SDN) and Deep Dry Needling (DDN) on Range of Motion (ROM) and functional ability in subjects with upper trapezius MPS. Materials & Methods: This is a quasi-experimental study conducted on 50 patients with MPS of upper trapezius muscle. They were randomly divided into two groups of 25 treated with SDN and DDN. They were examined in Physiotherapy Clinic of Iran University of Medical Sciences during 2016-2017. Neck disability and cervical ROM were measured using Neck Disability Index (NDI) instrument a goniometer, respectively. The subjects were evaluated before the treatment, after the treatment, and 7-and 15-day follow-up periods. The Independent t-test and ANOVA were used to compare the two groups at different times of evaluation. Results: There was no significant difference between SDN and DDN groups in terms of age (P=0.41), weight (P=0.99), and height (P=0.51). Interaction effect between group and time on the lateral cervical ROM over the unaffected side and NDI were significant (P<0.001). The simple main effect of time and group on NDI and ROM were also significant (P<0.001). Conclusion: The changes in the ROM and NDI were observed over time when SDN and DDN techniques were used, but these changes were more significant in patients treated with DDN, especially in the follow-up periods. Keywords: Myofascial Pain Syndrome, Disability, Neck pain, Range of Motion
Function and Disability Journal, 2021
Background and Objectives: The purpose of the present study was to examine the effectiveness of dry needling as local treatment of upper trapezius trigger points related to chronic neck pain on pain and pain pressure threshold in women with chronic nonspecific neck pain. Methods: Thirty females with an active myofascial trigger point of the upper trapezius muscle were randomly divided into two groups: dry needling with passive stretch (n=15) and passive stretch alone (n=15). They received 5 sessions of the intervention for three weeks. The outcomes were pain intensity and pain pressure threshold. Every outcome was recorded at baseline and 2 days after the fifth session. Results: Significant improvement in pain and pain pressure threshold was observed in both groups (P=0.0001) after the treatment. The results of the independent t-test showed a significant difference in measurements between the dry needling and passive stretch groups (P<0.05). Conclusion: Dry needling with passive s...
The Journal of Alternative and Complementary Medicine, 2012
Objectives: This trial was conducted to assess the effectiveness of interactive neurostimulation (INS) therapy on the treatment of pain associated with myofascial trigger points (MTPs) in adults with mechanical neck pain. Design: This was a preliminary, randomized, sham-controlled trial. Setting: The trial was conducted in a tertiary-care institution. Subjects: The participants were 23 adults with pain and MTPs in the neck or shoulder lasting > 2 weeks. Interventions: INS (active or sham) was delivered for 10 minutes in a single session over the MTP area in each patient. Outcome measures: Immediately following the intervention, subjects were tested for pressure pain thresholds (PPTs) and 10-cm visual analogue scale score (VAS) for pain intensity. At the 5 day follow-up, two additional tests were performed: the neck disability index (NDI) and the patient specific functional scale (PSFS) for function. Results: Improvements in function (PSFS) were observed in the treatment group, which were of clinical significance in selected subjects. These effects were statistically greater than those obtained in the sham group but were overall not at a level of clinical significance in this small population. Improvements in pain intensity (VAS) and neck disability (NDI) were observed in both the treatment and sham groups, indicating that INS had no greater benefit using these measures. There was no change in PPTs following either the active or sham treatment. Conclusions: INS is a new and emerging therapy, which may be efficacious for managing musculoskeletal conditions, such as myofascial pain syndrome. This study demonstrated improvements in function in individuals with MTPs following INS therapy, which may be of clinical significance in certain patients with neck or shoulder pain. Further large-scale clinical trials are required to confirm this effect and to determine if INS also reduces pain and neck disability.
PM&R, 2018
Background: Previous studies in asymptomatic subjects have demonstrated that myofascial trigger point (MTrP) dry needling frequently is associated with postneedling soreness. However, to the authors' knowledge, there is not any study that performs a detailed description of postneedling soreness characteristics in patients with myofascial pain. This information could help clinicians to make evidence-informed decisions considering the benefits and negative effects of different dry needling dosages. Objective: We sought (1) to compare the prevalence, intensity, and duration of postneedling soreness and tenderness after different dosages of deep dry needling (DDN) and (2) analyze the influence on postneedling soreness of psychological factors and other factors involved in the DDN process Design: A 1-week follow-up, double-blind randomized controlled trial. Setting: University community. Participants: Patients (n ¼ 120: 34 male; 86 female) aged 18-53 years (median AE interquartile range, 21.0 AE 7.0 years) with active MTrPs in the upper trapezius. Intervention: All patients received DDN in an active MTrP. They were randomly divided into 4 groups: no local twitch responses (LTRs) elicited (control group), 4 LTRs elicited, 6 LTRs elicited, and DDN until no more LTRs were elicited. Main outcome measures: Postneedling soreness and pressure pain threshold were assessed before treatment, during DDN procedure, and every 24 hours during 1 week. Results: Postneedling soreness showed a significant effect for time (F 2,006 ¼ 173.603; P < .001, h p 2 ¼ 0.659) and a significant interaction between group and time (F 6,017 ¼ 3.763; P ¼ .001; h p 2 ¼ 0.111). Pressure pain threshold showed a significant effect for time (F 2,377 ¼ 16.833; P < .001; h p 2 ¼ 0.127) and a significant interaction between group and time (F 7,130 ¼ 2.100; P ¼ .04; h p 2 ¼ 0.052). Psychological factors did not show relevant correlations with the intensity of postneedling soreness. Conclusions: Postneedling soreness is present in most of subjects after DDN of active MTrPs. The groups in which DDN was performed eliciting LTRs exhibited greater post-needling soreness. The number of needle insertions was associated with postneedling soreness but psychological factors did not seem to play a relevant role on its perception.