Corrigendum to: “Localization of Muscle Edema and Changes on Muscle Contractility After Dry Needling of Latent Trigger Points in the Gastrocnemius Muscle”, Pain Medicine, Volume 20, Issue 7, July 2019, Pages 1387–1394, https://doi.org/10.1093/pm/pny306

In this article, we aimed to describe what happens in skeletal muscle after dry needling intervention using magnetic resonance imaging (to show if there is edema) and tensiomyography (to measure contractile properties). At the same time, we describe the relationship between pain, edema, and contractility. Our results suggest that in asymptomatic patients, the application of dry needling over latent trigger points produce intra-muscular edema, an increase in muscle stiffness and an improved muscle contraction time.

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Effects of Dry Needling of Latent Trigger Points on Viscoelastic and Muscular Contractile Properties: Preliminary Results of a Randomized Within-Participant Clinical Trial

Journal of Clinical Medicine ◽

10.3390/jcm10173848 ◽

2021 ◽

Vol 10 (17) ◽

pp. 3848

Author(s):

Albert Pérez-Bellmunt ◽

Oriol Casasayas-Cos ◽

Carlos López-de-Celis ◽

Jacobo Rodríguez-Sanz ◽

Jorge Rodríguez-Jiménez ◽

...

Keyword(s):

Clinical Trial ◽

Range Of Motion ◽

Pain Sensitivity ◽

Gastrocnemius Muscle ◽

Trigger Points ◽

Neuromuscular Function ◽

Medial Gastrocnemius ◽

Single Session ◽

Dry Needling ◽

Pressure Pain

This study aimed to evaluate changes in neuromuscular function and pain perception in latent trigger points (TrPs) in the gastrocnemius muscle after a single session of dry needling. A randomized within-participant clinical trial was conducted. Fifty volunteers with latent TrPs in the gastrocnemius muscles were explored. Each extremity was randomly assigned to a control or experimental (dry needling) group. Viscoelastic parameters and contractile properties were analyzed by tensiomyography. Ankle dorsiflexion range of motion was assessed with the lunge test. Pressure pain thresholds (PPT) and pain perceived were also analyzed. The results observed that three viscoelastic proprieties (myotonometry) showed significant differences in favor of the experimental extremity in the lateral gastrocnemius: stiffness (p = 0.02), relaxation (p = 0.045), and creep (p = 0.03), but not in the medial gastrocnemius. No changes in tensiomyography outcomes were found. The control extremity showed a higher increase in PPTs (i.e., decrease in pressure pain sensitivity) than the experimental extremity (p = 0.03). No significant effects for range of motion or strength were observed. In general, gender did not influence the effects of dry needling over latent TrPs in the gastrocnemius muscle. In conclusion, a single session of dry needling was able to change some parameters of neuromuscular function, such as muscle tone, relaxation, pressure pain sensitivity, and creep in the lateral (but not medial) gastrocnemius but did not improve strength or range of motion.

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Dry needling of the gastrocnemius muscle. Overlap between trigger point area and the presence of blood vessels

Revista Fisioterapia Invasiva ◽

10.1055/s-0039-3401854 ◽

2019 ◽

Vol 02 (02) ◽

pp. 063-063

Author(s):

Velasco Fernández P. ◽

Valera Garrido F.

Keyword(s):

Blood Vessels ◽

Gastrocnemius Muscle ◽

Trigger Point ◽

Trigger Points ◽

Medial Gastrocnemius ◽

Dry Needling ◽

Lateral Gastrocnemius ◽

Myofascial Trigger Points ◽

Gastrocnemius Muscles ◽

Venous Pattern

Abstract Aims To evaluate the anatomic variability of the gastrocnemius venous system using ultrasound and the overlap of the same with myofascial trigger points (MTrPs 1 and 2) clinically located in this muscle. Material and Methods In total, 82 legs of 41 healthy adults were studied, belonging to 26 men and 15 women aged between 22 and 50 years. The blood vessels located below MTrP1 and MTrP2, described by Travell and Simons were observed, and each image was analyzed by sectors (medial, central and lateral) to quantify the number of blood vessels, their distribution and overlap with the MTrPs described at this level. Results Examination of the 164 heads of 82 gastrocnemius muscles revealed that at least one vessel exists for each section analyzed. The number of veins per head varied between 1 and 8. The most common pattern in the medial gastrocnemius was three vessels (41.5%) and two vessels (49%) in the lateral gastrocnemius. In 100% of the cases the localization of the veins coincided with the clinical localization of the MTrPs. Conclusions The venous pattern of the proximal gastrocnemius is highly variable among subjects regarding the number of blood vessels and their distribution. There is a complete overlap between the clinical localization of the gastrocnemius MTrPs and the presence of blood vessels.

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Electromyographic Activity Evolution of Local Twitch Responses During Dry Needling of Latent Trigger Points in the Gastrocnemius Muscle: A Cross-Sectional Study

Pain Medicine ◽

10.1093/pm/pnz182 ◽

2019 ◽

Vol 21 (6) ◽

pp. 1224-1229

Author(s):

Luis Baraja-Vegas ◽

Saúl Martín-Rodríguez ◽

Francisco Piqueras-Sanchiz ◽

Julio Martín-Ruiz ◽

Mireia Yeste Fabregat ◽

...

Keyword(s):

Gastrocnemius Muscle ◽

Trigger Points ◽

Cross Sectional Study ◽

Medial Gastrocnemius ◽

Peak Amplitude ◽

Emg Activity ◽

Sectional Study ◽

Dry Needling ◽

Cross Sectional ◽

Gastrocnemius Medialis

Abstract Objective Trigger points (TrPs) are hypersensitive spots within taut bands of skeletal muscles that elicit referred pain and motor changes. Among the variety of techniques used for treating TrPs, dry needling is one of the most commonly applied interventions. The question of eliciting local twitch responses (LTRs) during TrP dry needling is unclear. Our main aim was to investigate the evolution of the electromyographic (EMG) peak activity of each LTR elicited during dry needling into latent TrPs of the gastrocnemius medialis muscle. Methods Twenty asymptomatic subjects with latent TrPs in the gastrocnemius medialis muscle participated in this cross-sectional study. Changes in EMG signal amplitude (root mean square [RMS]) with superficial EMG were assessed five minutes before, during, and five minutes after dry needling. The peak RMS score of each LTR was calculated (every 0.5 sec). Results Analysis of variance revealed a significant effect (F = 29.069, P <0.001) showing a significant decrease of RMS peak amplitude after each subsequent LTR. Differences were significant (P <0.001) during the first three LTRs, and stable until the end of the procedure. No changes (P =0.958) were found for mean RMS data at rest before (mean = 65.2 mv, 95% confidence interval [CI] = 47.3–83.1) and after (61.0 mv, 95% CI = 42.3–79.7) dry needling. Conclusions We found that, in a series of LTRs elicited during the application of dry needling over latent TrPs in the medial gastrocnemius muscle, the RMS peak amplitude of each subsequent LTR decreased as compared with the initial RMS peak amplitude of previous LTRs. No changes in superficial EMG activity at rest were observed after dry needling of latent TrPs of the gastrocnemius medialis muscle.

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Inhibition of Peripheral ERK Signaling Ameliorates Persistent Muscle Pain Around Trigger Points in Rats

Cell Transplantation ◽

10.1177/0963689720960190 ◽

2020 ◽

Vol 29 ◽

pp. 096368972096019

Author(s):

Yu-Chang Zhu ◽

Fei-Hong Jin ◽

Ming-Yang Zhang ◽

Feng Qi

Keyword(s):

Animal Model ◽

Signaling Pathway ◽

Muscle Pain ◽

Gastrocnemius Muscle ◽

Pain Threshold ◽

Myofascial Pain ◽

Muscle Cells ◽

Trigger Points ◽

Erk Signaling ◽

Mechanical Pain Threshold

The purpose of this study was to investigate whether the ERK signaling pathway was involved in ameliorating chronic myofascial hyperalgesia from contused gastrocnemius muscle in rats. We established an animal model associated with myofascial pain syndrome and described the mechanism of muscle pain in an animal model. Changes in the mechanical pain threshold were observed 0.5, 1, 2, 3, 4, 5, 8, 12, 18, and 24 h after ERK inhibitor injection around myofascial trigger points (MTrPs) of the gastrocnemius muscle in rats. Morphological changes in gastrocnemius muscle cells were observed by hematoxylin and eosin (H&E) staining. ERK signaling pathway activation was detected through immunohistochemistry and Western blotting. The main morphological characteristics of injured muscle fibers around MTrPs include gathered circular or elliptical shapes of different sizes in the cross-section and continuous inflated and tapering fibers in the longitudinal section. After intramuscular injection of U0126 (ERK inhibitor), the mechanical pain threshold significantly increased. The reduction in mechanical hyperalgesia was accompanied by reduced ERK protein phosphorylation, myosin light chain kinase (MLCK) protein, p-MLC protein expression, and the cross-sectional area of skeletal muscle cells around MTrPs. An ERK inhibitor contributed to the attenuation of mechanical hyperalgesia in the rat myofascial pain model, and the increase in pain threshold may be related to MLCK downregulation and other related contraction-associated proteins by ERK.

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The effect of dry needling on gastrocnemius muscle stiffness and strength in participants with latent trigger points

Journal of Electromyography and Kinesiology ◽

10.1016/j.jelekin.2020.102479 ◽

2020 ◽

Vol 55 ◽

pp. 102479

Author(s):

S.R. Albin ◽

S.L. Koppenhaver ◽

C.W. MacDonald ◽

S. Capoccia ◽

D. Ngo ◽

...

Keyword(s):

Gastrocnemius Muscle ◽

Trigger Points ◽

Muscle Stiffness ◽

Dry Needling

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Dry needling increases antioxidant activity and grip force in a rat model of muscle pain

Acupuncture in Medicine ◽

10.1177/09645284211056941 ◽

2021 ◽

pp. 096452842110569

Author(s):

Daniel Tassinari Felber ◽

Rafael Tamborena Malheiros ◽

Victor Novo Tentardini ◽

Andréia Caroline Fernandes Salgueiro ◽

Francisco José Cidral-Filho ◽

...

Keyword(s):

Rat Model ◽

Muscle Pain ◽

Grip Force ◽

Gastrocnemius Muscle ◽

Scientific Evidence ◽

Thermal Hyperalgesia ◽

Thiobarbituric Acid ◽

Antioxidant Response ◽

Saline Group ◽

Dry Needling

Background: Muscle pain syndromes (MPS) are one of the main causes of functional, structural and metabolic problems, being associated with tissue oxidative damage. Although dry needling is widely used in the treatment of MPS, there is little scientific evidence of its efficacy and underlying mechanisms of action. Objectives: To investigate the effects of different dry needling techniques on thermal and mechanical hyperalgesia, locomotor and functional activity, and oxidative stress markers in a rat model of muscle pain. Methods: A total of 48 male Wistar rats underwent injection of the gastrocnemius muscle with control neutral saline (pH 7) and remained untreated (Saline group), or acidic saline (pH 4) and remained untreated (ASA group) or received pregabalin (PG group), deep needling (DN group), superficial needling (SN group) or twitch needling (TN group) with n = 8 rats per group. Mechanical (von Frey test) and thermal hyperalgesia (acetone test), muscle edema (assessed with a caliper), strength and muscle function (grip force evaluation), surface thermography and locomotor and exploratory activities (open field test) were evaluated. The animals were then euthanized, and the gastrocnemius muscle was excised for assessment of oxidative analyses of lipid peroxidation with thiobarbituric acid reactive species (TBA-RS) and total glutathione (GSH) levels. Results: All treatments significantly improved muscle strength and function when compared to the AS group (p < 0.05). Pregabalin reduced locomotor and exploratory activities, while the TN intervention increased the antioxidant response (p < 0.05). Conclusion: Dry needling improved strength, functionality and locomotor activity in a rat model of muscle pain. Twitch needling induced an antioxidant effect.

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The effect of dry needling of myofascial trigger points on muscle stiffness and motoneuron excitability in healthy subjects

Acupuncture in Medicine ◽

10.1177/09645284211027579 ◽

2021 ◽

pp. 096452842110275

Author(s):

Carolina Jiménez-Sánchez ◽

Julio Gómez-Soriano ◽

Elisabeth Bravo-Esteban ◽

Orlando Mayoral-del Moral ◽

Pablo Herrero-Gállego ◽

...

Keyword(s):

Muscle Tone ◽

Intervention Group ◽

Trigger Points ◽

Muscle Stiffness ◽

Invasive Technique ◽

Control Group ◽

Dry Needling ◽

Myofascial Trigger Points ◽

Motoneuron Excitability

Background: Myofascial trigger points (MTrPs) are hypersensitive nodules in a taut band (TB) of skeletal muscle. Dry needling (DN) is an invasive technique recommended for the treatment of MTrPs. However, to our knowledge, no studies have investigated the influence of the DN technique on modification of muscle stiffness and neurophysiological properties of MTrPs. Objective: The objective was to examine the effect of DN on muscle stiffness and motoneuron excitability of a latent medial MTrP (nodule and TB) of the soleus muscle in non-injured subjects. Methods: A double-blinded randomised controlled trial of 46 subjects with latent medial MTrPs of the soleus was conducted, in which all received one session of DN. The intervention group (n = 23) were subjected to DN into the MTrP (the nodule), while the control group (n = 23) were subjected to DN into the TB. Assessment was carried out at baseline (pre-test), after the intervention (post-test) and 1 week after the intervention (follow-up). Biomechanical variables (muscle resistive force at 10°/s and 180°/s, muscle extensibility and strength), as measured with an isokinetic dynamometer, and neurophysiological variables (H-reflex), were recorded. Results: There were no statistically significant differences in biomechanical or neurophysiological assessments between groups. Considering the intra-group analysis, subjects in the intervention group exhibited increased maximal isometric voluntary force to ankle plantarflexion (MIVFp) at both post-intervention and follow-up assessment (p < 0.0125; 0.2 < d < 0.5), while no changes were found in the control group. Conclusion: One session of DN targeting latent MTrPs did not change muscle stiffness, muscle extensibility or motoneuron excitability. Further research on subjects with muscle tone disorders should be considered to better address the impact of DN on muscle tone. Trial registration number: NCT02575586 (ClinicalTrials.gov).

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