EFFECTIVENESS OF DRY NEEDLING, STRETCHING, AND STRENGTHENING TO REDUCE PAIN AND IMPROVE FUNCTION IN SUBJECTS WITH CHRONIC LATERAL HIP AND THIGH PAIN: A RETROSPECTIVE CASE SERIES (original) (raw)
Related papers
THE USE OF DRY NEEDLING FOR A SUBJECT WITH CHRONIC LATERAL HIP AND THIGH PAIN: A CASE REPORT
Background and Purpose: Lateral thigh pain, commonly referred to as greater trochanteric pain syndrome (GTPS) and/ or iliotibial band syndrome (ITBS) is commonly treated by the physical therapist. Lateral thigh pain is commonly treated by the physical therapist. The sources of lateral thigh pain are commonly attributed to GTPS and/ or ITBS though various pathologies may contribute to this pain, of which trigger points (TrPs) may be an etiology. Dry needling (DN) is an intervention utilized by physical therapists where a monofilament needle is inserted into soft tissue in order to reduce pain to improve range of motion/ motor control dysfunction. This can assist with facilitation of return to prior level of function. The purpose of this case report is to report the outcomes of a patient with lateral hip and thigh pain treated with DN as a primary intervention strategy. Case Description: The subject was an active 78-year-old female recreational walker who was referred to physical therapy for chronic left lateral hip and thigh pain of greater than one-year duration without a clear mechanism of injury. She had a history of previous physical therapy treatment for the same condition, and previous therapeutic intervention strategies were effective for approximately two to three months duration prior to return of pain symptoms. Physical examination supported a diagnosis of GTPS/ ITBS. Subjective reports denoted sleep deficit due to pain lying on the left side at night and difficulty walking more than five minutes. Objective findings included decreased strength of the hip musculature and reproduction of pain symptoms upon flat palpation in specific locations throughout the lateral hip and thigh regions. She was treated for eight weeks using only DN to determine the effectiveness of DN as a primary intervention strategy, as previous physical therapy interventions were inconsistent and were only beneficial in the short-term. Outcomes: Clinically meaningful improvements were noted in disability and pain, as measured by the Lower Extremity Functional Scale and Quadruple Visual Analog Scale. Improvement in strength was not an objective measure being assessed, however, lower extremity strength improvement was noted upon final physical examination. This case report focused on pain reduction for improved function rather than strength improvement. Improvements in pain and disability were subjectively reported. The subject was able to lie on her left side at night, which improved her ability to sleep. She was also able to tolerate walking approximately twenty to thirty minutes for improved community ambulation needs. Discussion: This case report presents promising outcomes for the use of DN in the treatment of chronic lateral hip and thigh pain. Further research is recommended to determine if DN is clinically beneficial independent of other therapeutic interventions such as exercise, myofascial release/ massage, non-thrust mobilization, or manipulation. Level of evidence: Level 4 Key words: Dry needling; hip pain; iliotibial band; trochanteric bursitis
Complementary Therapies in Medicine, 2020
To determine the changes produced by dry needling in active myofascial trigger points in hip muscles compared to a sham needling on pain intensity, main pain area, pressure pain threshold and psychological distress in patients with hip osteoarthritis. Design: Secondary analysis of a single-centre, randomized, double-blinded, clinical trial. Intervention: 30 participants with mild to moderate hip osteoarthritis were randomly assigned to DN group (n = 15) or sham DN group (n = 15). DN group received three sessions of penetrating DN, and sham DN group received three sessions of non-penetrating DN in hip muscles. Main outcome measures: Pain intensity (Visual Analogue Scale), main pain area (body chart), pressure pain threshold (algometry), psychological distress (Hospital Anxiety and Depression Scale) and self-reported improvement (Global Rate of Change) were measured before and after treatment. Results: DN group showed statistically significant improvements with large effect sizes for pain intensity (p < 0.001; E.S: 2.7), pressure pain thresholds (p < 0.05; E.S: 1.3-1.8) and psychological distress (p = 0.002; E.S: 1.5) compared to sham DN group. The DN group described a self-reported improvement categorised as quite a bit, great or very great deal better (n = 12, 80%). No statistically significant differences were found between baseline and postintervention in the sham DN group in any variable (p > 0.05). Conclusions: Three sessions of dry needling were more effective than sham dry needling for improving pain intensity, pressure pain threshold and psychological distress in patients with mild to moderate hip osteoarthritis in the short term.
The Scientific World Journal
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...
Dry needling in the management of musculoskeletal pain
The Journal of the American Board …, 2010
Myofascial pain is a common syndrome seen by family practitioners worldwide. It can affect up to 10% of the adult population and can account for acute and chronic pain complaints. In this clinical narrative review we have attempted to introduce dry needling, a relatively new method for the management of musculoskeletal pain, to the general medical community. Different methods of dry needling, its effectiveness, and physiologic and adverse effects are discussed. Dry needling is a treatment modality that is minimally invasive, cheap, easy to learn with appropriate training, and carries a low risk. Its effectiveness has been confirmed in numerous studies and 2 comprehensive systematic reviews. The deep method of dry needling has been shown to be more effective than the superficial one for the treatment of pain associated with myofascial trigger points. However, over areas with potential risk of significant adverse events, such as lungs and large blood vessels, we suggest using the superficial technique, which has also been shown to be effective, albeit to a lesser extent.
International Journal of Research in Medical Sciences, 2018
Background: The roles of physiotherapists in managing the chronic and acute pain in musculoskeletal (Msk) conditions are inevitable now days. Physiotherapists work across the time period aiding patients with their pain in medical care settings with the aim of decreasing pain, rising quality of life wherever attainable and preventing acute and sub-acute painful conditions developing into chronic pain. Dry needling, an invasive technique in the hand of Physios is a new trend in managing acute and chronic pain. Purpose of the study is to identify the immediate and delayed response of pain and presence of soreness after the dry needling in common Msk conditions which can be managed in association with other conventional physical therapy techniques. Objective was to find out the immediate and delayed effects of dry needling over pain in musculoskeletal disorders. Methods: This study was carried out in the department of physiotherapy, Malabar medical college hospital and research centre. Patient was prepared and identified the extreme tender point over the muscle affected and needle removed after 3-5 twitch response elicited. Sterility of the treatment area and needle was well maintained. Prior to the treatment again confirmed with the NPRS score and procedure was done. After few seconds of insertion of needle subjects NPRS score assessed. After removal of needling pain score was assessed after 5 mins, 30 mins, 1 hour and after one day. Results: Study showed a marked reduction in pain after dry needling at each intervals and this suggesting promoting dry needling as an adjunct to pain relief technique in physiotherapy. Conclusions: Dry needling is effective over pain in musculoskeletal disorders.
The role of a dry needling technique in pain reduction
Journal of Health Sciences
Introduction: Dry needling is a therapeutic procedure using the insertion of thin needles through the skin into myofascial trigger points (MTrPs), muscular or connective tissue with the aim to reduce pain intensity. The objective of this systematic review is to analyze the literature for the efficacy of the dry needle technique in pain reduction in conditions of musculoskeletal pain caused by MTrPs. Reference Sources: Web of Science, Scopus and EBSCOhost database were searched for studies and e-books published from January 2010 to December 2018. Studies Selection: We included randomized controlled studies, prospective and longitudinal studies, and case studies which analyzed the efficacy of dry needling for musculoskeletal pain reduction. Data Extraction Method: The studies, which satisfied criteria for inclusion were further analyzed. The primary instrument of the evaluation was pain intensity analyses. Results: Dry needling treatment is efficient in pain intensity reduction in pat...
Scandinavian Journal of Pain, 2021
Objectives To assess the immediate and three days postintervention effect of one dry needling session compared to one sham needling session on pain, central pain processing, muscle co-contraction and spatiotemporal parameters during gait in knee osteoarthritis patients. Methods A double-blind randomized controlled trial was conducted. Sixty-one knee osteoarthritis patients were randomly assigned to the dry needling or sham needling group. Primary outcomes were pain and central pain processing. Secondary outcomes included muscle co-contraction and spatiotemporal parameters during gait. Patients were assessed at baseline and 15 min after the intervention, and pain also three days after the intervention. Linear mixed models were used to examine between- and within-group differences. Results No significant between-group differences for pain were found, but within-group scores showed a significant decrease 15 min after sham needling and three days after dry needling. The mean conditioned...
J Res Med Sci, 2016
Background: Disk herniation is the most common cause of radiating LBP in subjects under 60 years of age. The present study aims to compare the effect of dry needling and a standard conservative approach on the pain and function in subjects with discogenic radiating low back pain. Materials and Methods: Fifty-eight subjects with discogenic radicular low back pain were screened and randomized into control (Standard physical therapy, N = 29) and experimental group (Standard physical therapy & Dry needling, N = 29). Radiating pain intensity and disability were measured using Visual Analogue Scale and Oswestry Disability indices at baseline, at the end of treatment and two months after the last intervention session. the changes in pain intensity and disability were studied using a 3×2 repeated measures analysis of variance considering time as the within-subject factor and group as the between-subject. Results: Pain intensity and disability scores decreased significantly in both experimental and control groups (experimental group: VAS=37.24, ODI=28.48, control group: VAS=45.5, ODI=32.96), following the intervention. The change continued during the follow-up period (P<0.001 for all comparisons). Pain and disability improvement, however, were more significant in experimental group, both in post intervention (experimental group: VAS=25.17, ODI=22.17, control group: VAS=42.4, ODI=30.27) (P=0.05 and P=0.03, respectively) and in follow-up measures (P=0.006 and P=0.002, respectively).Conclusions: Both intervention strategies seem to significantly improve pain and disability immediately following intervention, where the improvement continued during two months after the last active intervention. Therefore, supplementary DN application may enhance the effect of the standard intervention considerably. Key Words: Low Back Pain, Discogenic, Dry needling.
Musculoskeletal Science and Practice, 2019
This study design, protocol and consent forms were performed in accordance with the Helsinki Declaration of 1964 (revised in Fortaleza, 2013). The ethical approval for this study was obtained from the Clinical Research Ethics Committee of Aragón (PI17/0182) and it was registered in ClinicalTrials.gov, NCT03202056. This manuscript is original and not previously published, nor it is being considered elsewhere until a decision is made as to its acceptability by the review board. Authors not declare conflicts of interest in this study. All the authors have been actively involved in the planning and enactment of the review, and have also assisted with the preparation of the submitted article. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Journal of Traditional Chinese Medicine, 2016
OBJECTIVE: To summarize the literature about the effectiveness of dry needling (DN) on relieving pain and increasing range of motion (ROM) in individuals with myofascial pain syndrome (MPS). METHODS: Papers published from January 2000 to January 2013 were identified through an electronic search in the databases MEDLINE, Dialnet, Cochrane Library Plus, Physiotherapy Evidence Database (PEDro) and Spanish Superior Council of Scientific Research (CSIC). The studies included were randomized controlled trials written in English and/or Spanish about the effectiveness of DN on pain and ROM in individuals with MPS. RESULTS: Out of 19 clinical trials that were potentially relevant, a total of 10 were included in the Me-ta-analysis. Regarding pain intensity reduction when measured before and immediately after the intervention, DN achieved improvement compared with the placebo treatment [d =-0.49; 95% CI (-3.21, 0.42)] and with the control group [d =-9.13; 95% CI (-14.70,-3.56)]. However, other treatments achieved better results on the same variable compared with DN, considering the measurements for pre-treatment and immediately after [d = 2.54; 95% CI (-0.40, 5.48)], as well as the pre-treatment and after 3-4 weeks [d = 4.23; 95% CI (0.78, 7.68)]. DN showed a significantly increased ROM when measured before the intervention and immediately after, in comparison with the placebo [d = 2.00; 95% CI (1.60, 2.41)]. However, other treatments achieved a significant better result regarding ROM when it was measured before the intervention and immediately after, as compared with DN [d =-1.42; 95% CI (-1.84,-0.99)]. CONCLUSION: DN was less effective on decreasing pain comparing to the placebo group. Other treatments were more effective than DN on reducing pain after 3-4 weeks. However, on increasing ROM, DN was more effective comparing to that of placebo group, but less than other treatments.