scholarly journals POS1096 THE EFFECT OF ONE DRY NEEDLING SESSION ON PAIN AND CENTRAL PAIN PROCESSING IN PATIENTS WITH KNEE OSTEOARTHRITIS: A RANDOMIZED CONTROLLED TRIAL

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 828.1-828
Author(s):  
S. Vervullens ◽  
L. Meert ◽  
I. Baert ◽  
N. Delrue ◽  
K. Heusdens ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Group Differences ◽  
Pain Processing ◽  
Dry Needling ◽  
Knee Oa ◽  
Pressure Threshold ◽  
Pain Pressure Threshold ◽  
Spatiotemporal Parameters ◽  
Central Pain Processing ◽  
Over Time

Background:Osteoarthritis (OA) is the leading cause of chronic disability in the elderly1,2. Abnormal central pain processing (CPP) is present in around 30% of the knee OA patients3 and can be partly induced by peripheral nociception through long term potentiation4. An attempt to resolve abnormal CPP can be to eliminate this nociception5. Myofascial trigger points (MTrPs) are often present in knee OA6, can lead to nociception7 and therefore abnormal CPP if prolonged present8. These are usually defined as hypersensitive tender spots within taut bands of a muscle9. Additionally, both MTrPs and knee OA can induce disturbed motor control, increased co-antagonist activation and modified gait pattern10,11. Dry needling (DN) is often used to deactivate the MTrP and thus resolve the source of nociception, which normally results in reducing pain and restoring muscle dysfunction12. However, studies about the effect of DN on CPP and other outcomes than pain are very limiting. Therefore, more high-quality studies concerning DN and its effects on CPP, muscle features and gait are needed13,14.Objectives:The aim of this randomized controlled trial is to assess the effect of one DN session compared to one sham needling (SN) session on pain (processing), muscle activity and gait in patients with knee OA.Methods:61 patients participated of which 31 were allocated to the DN and 30 to the SN group. Each patient underwent one treatment session. Primary outcomes were pain intensity, measured with questionnaires; and CPP, measured with quantitative sensory testing. Secondary outcomes included muscle co-activation, measured with electromyography; and spatiotemporal parameters, measured with gait analysis. Patients were assessed at baseline, 15 minutes (post 1) and 3 days after intervention (post2- only for the outcome pain). Linear mixed models was used to identify the possible differences over time between the two therapy modalities.Results:The following significant within group differences were observed: decreased pain, stride- and step time and increased widespread pain pressure threshold and step length. A significant between group difference of the conditioned pain modulation score was found, whereas the SN group showed a decrease in difference between the pain pressure threshold scores (with and without conditioning stimulus) and the DN group remained stable. No other significant between or within group differences were detected. However, if we compared both interventions, the change over time for the visual analogue scale (VAS) behaved different in the DN (p<0.05, post 2 - baseline) and SN group (p<0.05, post 1 - baseline and post 2 - post 1).Conclusion:One DN session has no larger effect on all outcome measurements compared to SN. Both therapies seem to be useful to improve pain and widespread pain pressure threshold in short term, however the improvement of pain differs in the groups. Although improvements in some spatiotemporal parameters were observed, it is uncertain they are of clinical relevance or related to treatment. More research is necessary to reveal the ideal number of sessions of DN to improve outcomes and to reveal the effect of DN compared to no treatment, as SN could have hide the real treatment effect.References:[1]Reginster, J. Y. Rheumatol. Oxf. 41 Supp 1, 3–6 (2002)[2]Lespasio, M. J. et al. Perm J 21, 16–183 (2017)[3]Lluch, E. et al. Eur J Pain 18, 1367–75 (2014)[4]Mease, P. J. et al. J. Rheumatol. 38, 1546–1551 (2011)[5]Nijs, J. et al. Expert Opin Pharmacother 15, 1671–83 (2014)[6]Bajaj, P. et al. J. Musculoskelet. Pain 9, 17–33 (2001)[7]Jafri, M. S. Int. Sch. Res. Not. 2014, (2014)[8]Cagnie, B. et al. Curr Pain Headache Rep 17, 348 (2013)[9]Borg-Stein, J. et al. Arch. Phys. Med. Rehabil. 83, S40–S47 (2002)[10]Childs, J. D. et al. Clin. Biomech. 19, 44–9 (2004)[11]Ibarra, J. M. et al. J Pain 12, 1282–8 (2011)[12]Rahou-El-Bachiri, Y. et al. J. Clin. Med. 9, (2020)[13]Stieven, F. F. et al. J. Manipulative Physiol. Ther. (2021)[14]Dor, A. et al. J Bodyw Mov Ther 21, 642–647 (2017)Figure 1.Mean and standard error of VAS scores over time in the DN and SN groupAcknowledgements:I like to thank and acknowledge the contribution of the other executive researchers (Lise Brosens, Ayoub El Bouchaoni, Ben Ceusters, Sven Huybrechts and Mathias Van Loon), the participated dry needling therapists, Dry Needling Ghent, Trigger and the University Hospital of Antwerp.Disclosure of Interests:None declared.

The effect of one dry needling session on pain, central pain processing, muscle co-contraction and gait characteristics in patients with knee osteoarthritis: a randomized controlled trial

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Sophie Vervullens ◽  
Lotte Meert ◽  
Isabel Baert ◽  
Nicolas Delrue ◽  
Christiaan H. W. Heusdens ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Controlled Trial ◽  
Pain Modulation ◽  
Group Differences ◽  
Conditioned Pain Modulation ◽  
Pain Processing ◽  
Central Pain ◽  
Dry Needling ◽  
Spatiotemporal Parameters ◽  
Central Pain Processing

Abstract 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 pain modulation effect measured at the m. Trapezius worsened significantly 15 min after sham needling compared to after dry needling (between-group difference). However, individual conditioned pain modulation percentage scores remained stable over time. Various significant within-group differences were found 15 min after sham needling: a decrease of conditioned pain modulation measured at m. Quadriceps and m. Trapezius and stride- and step-time scores, and an increase in step length and widespread pain pressure threshold. A significant decrease in muscle co-contraction index of the m. Vastus Medialis and Semitendinosus was found as within-group difference 15 min after dry needling. Conclusions Dry needling has no larger effect on pain, central pain processing, muscle co-contraction and gait pattern 15 min and three days postintervention compared to sham needling. Mean conditioned pain modulation scores worsened after sham needling compared to after dry needling. Further research remains necessary.

Trigger Point Dry Needling versus Strain–counterstrain Technique for Upper Trapezius Myofascial Trigger Points: A Randomised Controlled Trial

2016 ◽  
Vol 34 (3) ◽  
pp. 171-177 ◽  
Author(s):  
E Segura-Ortí ◽  
S Prades-Vergara ◽  
L Manzaneda-Piña ◽  
R Valero-Martínez ◽  
JA Polo-Traverso
Keyword(s):  
Randomised Controlled Trial ◽  
Trigger Point ◽  
Controlled Trial ◽  
Trigger Points ◽  
Dry Needling ◽  
Significant Group ◽  
Myofascial Trigger Points ◽  
Upper Trapezius ◽  
Pain Pressure Threshold ◽  
Randomised Controlled

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.

Superficial Dry Needling and Active Stretching in the Treatment of Myofascial Pain – a Randomised Controlled Trial

2003 ◽  
Vol 21 (3) ◽  
pp. 80-86 ◽  
Author(s):  
Janet Edwards ◽  
Nicola Knowles
Keyword(s):  
Randomised Controlled Trial ◽  
Myofascial Pain ◽  
Short Form ◽  
Controlled Trial ◽  
Group Differences ◽  
Mcgill Pain Questionnaire ◽  
Dry Needling ◽  
Randomised Controlled ◽  
Availability Assessment ◽  
Stretching Exercises

A pragmatic, single blind, randomised, controlled trial was conducted to test the hypothesis that superficial dry needling (SDN) together with active stretching is more effective than stretching alone, or no treatment, in deactivating trigger points (TrPs) and reducing myofascial pain. Forty patients with musculoskeletal pain, referred by GPs for physiotherapy, fulfilled inclusion / exclusion criteria for active TrPs. Subjects were randomised into three groups: group 1 (n=14) received superficial dry needling (SDN) and active stretching exercises (G1); group 2 (n=13) received stretching exercises alone (G2); and group 3 (n=13) were no treatment controls (G3). During the three-week intervention period for G1 and G2, the number of treatments varied according to the severity of the condition and subject/clinician availability. Assessment was carried out pre-intervention (M1), post-intervention (M2), and at a three-week follow up (M3). Outcome measures were the Short Form McGill Pain Questionnaire (SFMPQ) and Pressure Pain Threshold (PPT) of the primary TrP, using a Fischer algometer. Ninety-one per cent of assessments were blind to grouping. At M2 there were no significant inter-group differences, but at M3, G1 demonstrated significantly improved SFMPQ versus G3 (p=0.043) and significantly improved PPT versus G2 (p=0.011). There were no differences between G2 and G3. The mean PPT and SFMPQ scores correlated significantly in G1 only, though no significant inter-group differences were demonstrated. Numbers of patients requiring further treatment following the trial were: 6 (G1); 12 (G2); 9 (G3). Conclusion: SDN followed by active stretching is more effective than stretching alone in deactivating TrPs (reducing their sensitivity to pressure), and more effective than no treatment in reducing subjective pain. Stretching without prior deactivation may increase TrP sensitivity.

scholarly journals The Effect of Hamstring Relaxation Program on Headache, Pressure Pain Threshold, and Range of Motion in Patients with Tension Headache: A Randomized Controlled Trial

2021 ◽  
Vol 18 (19) ◽  
pp. 10137
Author(s):  
Soon-Hyun Kwon ◽  
Eun-Jung Chung ◽  
Jin Lee ◽  
Sang-Woo Kim ◽  
Byoung-Hee Lee
Keyword(s):  
Range Of Motion ◽  
Controlled Trial ◽  
Pressure Pain Threshold ◽  
Tension Headache ◽  
Control Group ◽  
Positive Effects ◽  
Pressure Threshold ◽  
Digital Pressure ◽  
Pain Pressure Threshold ◽  
Pressure Algometer

The purpose of this study was to determine if the severity of headache is reduced by decreasing hamstring tension in patients with tension headache. Thirty patients participated in this study. The participants were randomly allocated to two groups: hamstring relaxation program (HR) group (n = 15) and control group (n = 15). The participants in the HR group participated in a HR program for 25 min per day, three times per week, for a period of 4 weeks, and the control group participated in an electrotherapy for 25 min per day, three times per week, for a period of 4 weeks. Both groups participated in a self-myofacial release for 5 min per day, three times per week, for a period of 4 weeks. Headache was evaluated using the headache impact test (HIT-6) and visual analog scale (VAS). The pain pressure threshold (PPT) was evaluated using a digital pressure algometer. The range of motion (ROM) was evaluated using a goniometer and two special tests: straight leg raise test (SLRT) and popliteal angle test (PAT). The two groups showed no significant differences in terms of age, sex, height, and weight. The VAS and HIT-6 scores (p < 0.05) and neck and hamstring PPT showed significant improvements (p < 0.05). Neck flexion ROM and SLRT and PAT scores showed significant improvements (p < 0.05) in both groups, and the HR group showed significantly more improvements than the control group. This study confirmed that the HR program has positive effects on tension headache and is a good intervention for alleviating headaches in patients with tension headache.

Analysis and comparison of pain pressure threshold and active cervical range of motion after superficial and deep dry needling techniques of the upper trapezius muscle

2021 ◽  
pp. 096452842110395
Author(s):  
Sergio Montero Navarro ◽  
Sonia del Rio Medina ◽  
José Martín Botella Rico ◽  
María Isabel Rocha Ortiz ◽  
María Teresa Pérez Gracia
Keyword(s):  
Range Of Motion ◽  
Gastrocnemius Muscle ◽  
Contralateral Side ◽  
Control Group ◽  
Dry Needling ◽  
Cervical Range Of Motion ◽  
Upper Trapezius ◽  
Pressure Threshold ◽  
Pain Pressure Threshold ◽  
Asymptomatic Volunteers

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 )

scholarly journals Dry needling in the deactivation of myofascial trigger points

2021 ◽  
Author(s):  
Elaine Cruz ◽  
Davi Rodrigues Martins ◽  
Richarlison Amaral ◽  
Rodrigo Manhães ◽  
Mairkon Almeida Soares
Keyword(s):  
Clinical Trials ◽  
Range Of Motion ◽  
Randomized Clinical Trials ◽  
Trigger Point ◽  
Pressure Pain Threshold ◽  
Trigger Points ◽  
Dry Needling ◽  
Myofascial Trigger Points ◽  
Pressure Threshold ◽  
Pain Pressure Threshold

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.

Dry Needling Compared With Manual Pressure Trigger Point Manual Therapy for Improving Pain in Patients Experiencing Myofascial Neck Pain: A Critically Appraised Topic

2021 ◽  
pp. 1-8
Author(s):  
Alicea E. Taylor-Meza ◽  
Kelsey N. Bahe ◽  
Michael A. Trevino ◽  
Jennifer L. Volberding ◽  
Aric J. Warren
Keyword(s):  
Neck Pain ◽  
Manual Therapy ◽  
Trigger Point ◽  
Clinical Question ◽  
Dry Needling ◽  
Bottom Line ◽  
Low Level ◽  
Pressure Threshold ◽  
Pain Pressure Threshold ◽  
Manual Pressure

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.

Comparison of radial shockwave and dry needling therapies in the treatment of myofascial pain syndrome

2019 ◽  
Vol 26 (8) ◽  
pp. 1-8 ◽  
Author(s):  
Chomkajee Sukareechai ◽  
Somchai Sukareechai
Keyword(s):  
Myofascial Pain ◽  
Therapy Group ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Dry Needling ◽  
Back Muscles ◽  
Shockwave Therapy ◽  
Upper Trapezius ◽  
Pressure Threshold ◽  
Pain Pressure Threshold

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.

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
Keyword(s):  
Shoulder Pain ◽  
Trigger Point ◽  
Direct Application ◽  
Shoulder Impingement Syndrome ◽  
Dry Needling ◽  
Shoulder Impingement ◽  
Overhead Athletes ◽  
Upper Trapezius ◽  
Pressure Threshold ◽  
Pain Pressure Threshold

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.

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