Comparison of Upper Trapezius and Infraspinatus Myofascial Trigger Point Therapy by Dry Needling in Overhead Athletes With Unilateral Shoulder Impingement Syndrome

2019 ◽  
Vol 28 (3) ◽  
pp. 243-249 ◽  
Author(s):  
Fahimeh Kamali ◽  
Ehsan Sinaei ◽  
Maryam Morovati

Context: Chronic musculoskeletal disorders in the shoulder joint are often associated with myofascial trigger points (MTrPs), particularly in the upper trapezius (UT) muscle. Dry needling (DN) is a treatment of choice for myofascial pain syndrome. However, local lesions and severe postneedle soreness sometimes hamper the direct application of DN in the UT. Therefore, finding an alternative point of treatment seems useful in this regard. Objective: To compare the efficacy of UT versus infraspinatus (ISP) DN on pain and disability of subjects with shoulder pain. The authors hypothesized that ISP DN could be as effective as the direct application of DN in UT MTrP. Design: Single-blind randomized clinical trial. Setting: Sports medicine physical therapy clinic. Participants: A total of 40 overhead athletes (age = 36 [16] y; 20 females and 20 males) with unilateral shoulder impingement syndrome were randomly assigned to the UT DN (n = 21) and ISP DN (n = 19) groups. Intervention: An acupuncture needle was directly inserted into the trigger point of UT muscle in the UT DN group and of ISP muscle in the ISP DN group. DN was applied in 3 sessions (2-day interval between each sessions) for each group. Main Outcome Measures: Pain intensity (visual analog scale), pain pressure threshold, and disability in the arm, shoulder, and hand were assessed before and after the interventions. Results: Pain and disability decreased significantly in both groups (P < .001) and pain pressure threshold increased significantly only in the ISP group (P = .02). However, none of the outcome measures showed a significant intergroup difference after treatments (P > .05). Conclusions: Application of DN for active MTrPs in the ISP can be as effective as direct DN of active MTrPs in the UT in improving pain and disability in athletes with shoulder pain, and may be preferred due to greater patient comfort in comparison with direct UT needling.

2021 ◽  
Vol 4 (1) ◽  
pp. 29-29
Author(s):  
Fereshteh Navaee ◽  
◽  
Marzieh Yassin ◽  
Javad Sarrafzade ◽  
Reza Salehi ◽  
...  

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 stretch can be more effective on pain and pain pressure threshold than passive stretching alone in short term in women with nonspecific neck pain.


2016 ◽  
Vol 34 (3) ◽  
pp. 171-177 ◽  
Author(s):  
E Segura-Ortí ◽  
S Prades-Vergara ◽  
L Manzaneda-Piña ◽  
R Valero-Martínez ◽  
JA Polo-Traverso

Background Treatment of active myofascial trigger points includes both invasive and non-invasive techniques. Objectives To compare the effects of upper trapezius trigger point dry needling (DN) and strain–counterstrain (SCS) techniques versus sham SCS. Study Design Randomised controlled trial. Method 34 study subjects with active trigger points were randomly assigned to one of three treatment groups, and received either three sessions of DN (n=12), six sessions of SCS (n=10), or sham SCS (n=12) over a 3-week period. Subjective pain response and subjects’ own ratings of perceived disability were measured. Results The analysis of variance mixed model showed a significant time effect for pain (p<0.001), elicited pain (p<0.001), pain pressure threshold (p<0.01), and neck disability index (p=0.016). Pain at rest decreased in all groups, as follows: DN 18.5 mm (95% CI 4.3 to 32.7 mm); SCS 28.3 mm (95% CI 12.4 to 44.1 mm); sham SCS 21.9 mm (95% CI 3.5 to 40.1 mm). Reductions in disability score (points) were significant in the SCS group (5.5, 95% CI 1.6 to 9.4) but not in the DN (1.4, 95% CI −4.9 to 2.1) or sham SCS (1.8, 95% CI −6.4 to 2.7) groups. There was no significant group×time interaction effect for any variables studied. Conclusions There were no differences between the sham SCS, SCS, and DN groups in any of the outcome measures. DN relieved pain after fewer sessions than SCS and sham SCS, and thus may be a more efficient technique. Future studies should include a larger sample size. Trial Registration Number NCT01290653.


2021 ◽  
pp. 096452842110395
Author(s):  
Sergio Montero Navarro ◽  
Sonia del Rio Medina ◽  
José Martín Botella Rico ◽  
María Isabel Rocha Ortiz ◽  
María Teresa Pérez Gracia

Objectives: 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). Design: Double-blind, randomized controlled trial with 7-day follow-up. Participants: 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. Main outcome measures: 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. Results: 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. Conclusion: 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 )


2021 ◽  
Author(s):  
Elaine Cruz ◽  
Davi Rodrigues Martins ◽  
Richarlison Amaral ◽  
Rodrigo Manhães ◽  
Mairkon Almeida Soares

Dry Needling (DN) is a technique indicated to treat injuries of muscle origin and widely used in the deactivation of myofascial trigger points (PGMs). Its application almost always produces immediate effect, decreasing pain and increasing range of motion. The main objective of the present study was to verify the effectiveness of Dry Needling in the deactivation of myofascial trigger points. A search was carried out through three distinct databases and 10 articles dating from the last ten years were selected, with a score greater than or equal to six, in the classification of the PEDro platform (Physiotherapy Evidence Database). All selected articles were classified as randomized controlled trials, where eight are blind randomized clinical trials and two double blind randomized clinical trials. Outcomes ranged from decreased trigger points, increased range of motion, pain intensity and pain pressure threshold. The studies included in this review suggest that Dry Needling has a fundamental role in the treatment of PGMs, mainly increasing the pressure pain threshold, thus suggesting trigger point deactivation.


Author(s):  
Alicea E. Taylor-Meza ◽  
Kelsey N. Bahe ◽  
Michael A. Trevino ◽  
Jennifer L. Volberding ◽  
Aric J. Warren

Focused Clinical Question: What is the efficacy of dry needling (DN) compared to ischemic compression point therapy for improving pain and pain pressure threshold (PPT) in patients experiencing myofascial neck pain? Clinical Bottom Line: There is low-level evidence suggesting DN has the potential to elicit greater improvements in pain and PPT relief compared to ischemic compression techniques for individuals with myofascial neck pain.


2019 ◽  
Vol 26 (8) ◽  
pp. 1-8 ◽  
Author(s):  
Chomkajee Sukareechai ◽  
Somchai Sukareechai

Background/Aims Myofascial pain syndrome is a frequent problem in the musculoskeletal system. As a method of treatment for myofascial pain syndrome, dry needling therapy is an effective and convenient treatment for patients because they do not need to be treated every day. However, as patients often have post-needle soreness or some patients are afraid of needles, there are limitations to this treatment. The purpose of this study is to compare the effectiveness of radial shockwave therapy with dry needling therapy to treat myofascial pain. Methods A total of 42 patients attending the rehabilitation department with at least one myofascial pain trigger point in their upper back muscles, were randomly assigned to receive radial shockwave therapy or dry needling therapy. Treatment was performed once a week for 3 weeks in both groups. Participants' pain pressure threshold, measured using an algometer, and pain levels, measured using a numeric pain scale, were assessed before the designated treatment was applied each week. Each patient also performed upper trapezius, rhomboid and infraspinatus muscle stretches twice a day throughout the study period. Results There was no difference in pain pressure threshold at the three trigger points before treatment with the different modalities commenced. At the end of the study, the radial shockwave therapy group had a significant improvement in trapezius pain pressure threshold, increasing from 11.7 at baseline to 14.8 at the end of study. There was no significant between-group difference in pain level (P=3.4 vs P=2.6) at the end of the study. Both treatments significantly reduced pain levels: from 7.2 to 3.4 in the radial shockwave group (P<0.001) and from 6.8 to 2.6 in the dry needling therapy group (P<0.001). Conclusions Dry needling and radial shock wave therapies are effective in reducing myofascial pain syndrome originating in the upper back muscles. Participants' pain pressure threshold increased after 3 weeks of treatment with both therapies. Radial shock therapy can be used as an alternative to dry needling in the treatment of myofascial pain syndrome in patients who have trouble attending daily physical therapy or in whom dry needling therapy is contraindicated.


2019 ◽  
Vol 02 (02) ◽  
pp. 064-064
Author(s):  
Ciórraga López JL ◽  
Vega Moreu P.

Abstract Aims The aim of this research was to study the appearance of soreness after dry needling (DN) and percutaneous needle electrolysis (PNE) in latent trigger points of the extensor muscle of the posterior forearm region. Material and Methods A pre-test/post-test pilot study was performed, in which 15 volunteers with latent trigger points in the extensor muscles of the posterior forearm region were randomly distributed into a group A who received treatment with DN and a group B who received treatment with PNE. Before and after the intervention, algometry measurements were performed at the site where the trigger point was found, and, after the intervention the patient was asked to complete two visual analog scales (VAS) to evaluate pain during the intervention and a second scale to measure pain once the needle had been removed. In addition, the same scale was performed after 24 hours, 72 hours, and 1 week after the dry needling. The statistical analysis was performed using the SPSS program version 24.0, evaluating the normality of the variables using the Shapiro-Wilk test, as the sample was less than 50 subjects. P values of > 0.05 were considered normal. Results The ANOVA revealed a significant effect for time on the decrease of the VAS scores, both in the groups of dry needling (P < 0.001), as well as in the group of PNE (P < 0.001). In contrast, a group-time interaction was not observed (P = 0.824), ruling out statistically significant differences between the DN group and the PNE group. The Student's t-test showed a significantly decreased pain pressure threshold between the pre and post algometry, both in the group of DN (P < 0.001) and the group of PNE (P < 0.003). However, no statistically significant differences were found between both groups in pre and post algometry (P = 0.457). Conclusion All patients presented post-needling soreness, without significant differences between DN and PNE interventions. The most intense pain was registered minutes after the dry needling, which then decreased without significant differences, reaching 0 after 72 hours, in most cases. Neither of the two techniques caused increased pain in response to pressure in a significantly different manner. No relationship was observed between a greater number of LTRs and post-needling pain. There was a correlation between pain experienced during the intervention and pain 24 hours after the needling. The levels of post-intervention pain secondary to the application of DN and PNE in latent trigger points of the extensor muscles of the posterior forearm region did not present significant differences among study subjects in both intervention groups.


2020 ◽  
Vol 3 (1) ◽  
pp. 111-122
Author(s):  
Azizeh Parandnia ◽  
◽  
Marzieh Yassin ◽  
Javad Sarrafzadeh ◽  
Reza Salehi ◽  
...  

Background & Objectives: Myofascial Trigger Point (MTrP) is one of the most common musculoskeletal disorders. The MTrP includes highly sensitive points within a taut band, is painful to palpation, and causes pain in a specific pattern. The MTrP is more prevalent in the upper trapezius muscle because this muscle plays an important role in maintaining the posture of the head and neck. This study aimed to compare the effects of dry needling and high-intensity laser therapy on the clinical signs of females with active trigger points in the upper trapezius muscle. Methods: Thirty females with the active MTrP of the upper trapezius muscle were randomly assigned into two groups: high-intensity laser therapy group (n=15) and dry needling group (n=15); they received the interventions in five sessions for three weeks. The outcome measures included pain intensity and pain pressure threshold, which were assessed before and two days after the interventions. Results: In both study groups, the scores of the visual analogue scale of pain were significantly decreased, also, the pain pressure threshold was significantly increased (P=0.001), after the treatment. However, the two groups did not significantly differ in any of the outcome measures (P>0.05). Conclusion: Both high-intensity laser therapy and dry needling can be employed to treat the MTrP of the upper trapezius muscle. Considering the effectiveness of the two treatments, each of the methods can be alternatively selected for these patients.


2018 ◽  
Vol 23 (6) ◽  
pp. 246-252
Author(s):  
Saurabh Sharma ◽  
M. Ejaz Hussain

Patient-related outcome measures are often used for assessing and determining management efficacy of shoulder impingement syndrome (SIS) in overhead athletes. This study was undertaken to examine the psychometric properties (structural validity, convergent validity, internal consistency, test-retest reliability, and minimal detectable change) and perform partial confirmatory factor analysis (PCFA) of the Hindi SPADI. Eighty male athletes with a mean age of 21.5 ± 2.20 years were enrolled in the study. Hindi SPADI test-retest reproducibility was calculated by intraclass correlation coefficient (ICC2,1), and Cronbach alpha helped determine internal consistency of the index. Pearson correlation coefficient compared the Hindi SPADI with the Hindi DASH scale to determine convergent validity, while the measurement error was calculated by minimal detectable change (MDC95). Exploratory factor analysis utilized for assessing the structural validity of the index gave a five-factor solution, which explained 70.03% of the variances. The test-retest reliability (ICC2,1), internal consistency, and convergent validity were found to be high, at 0.87, 0.75, and 0.94, respectively. The MDC95was calculated to be 14.20. Additionally, the PCFA confirmed the five-factor solution with fit indices. This Hindi version of SPADI demonstrated satisfactory psychometric properties in overhead athletes with shoulder impingement syndrome.


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