Hemiparetic Shoulder Pain Syndrome Treated with Deep Dry Needling During Early Rehabilitation: A Prospective, Open-Label, Randomized Investigation

Abstract Objective To determine the short-term effect of graded motor imagery (GMI) on the affective components of pain and range of motion in subjects with chronic shoulder pain syndrome. Design Open-label single-arm prospective study. Setting The Physical Therapy Laboratory, Universidad de las Americas. Subjects One hundred seven patients with chronic shoulder pain syndrome. Methods The subjects received a six-week GMI program based on laterality training, imagined movements, and mirror therapy. We assessed pain intensity using a visual analog scale (VAS), fear of movement was assessed using the Tampa Scale of Kinesiophobia (TSK), and catastrophizing was assessed using the Pain Catastrophizing Scale (PCS). The patient’s flexion active range of motion (AROM) was also recorded. Results At the end of treatment, the VAS showed a decrease of 4.2 cm (P < 0.001, Cohen’s d = 3.3), TSK showed a decrease of 17.0 points (P < 0.001, Cohen’s d = 2.8), catastrophizing showed a decrease of 19.2 points (P < 0.001, Cohen’s d = 3.2), and shoulder flexion AROM showed an increment of 30.3º (P < 0.000, Cohen’s d = 1.6). Conclusions We conclude that a short-term GMI program improves the affective components of pain and shoulder flexion AROM in patients with chronic shoulder pain syndrome.

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Faculty Opinions recommendation of Effectiveness of dry needling on reducing pain intensity in patients with myofascial pain syndrome: a Meta-analysis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726199055.793524808 ◽

2016 ◽

Author(s):

Josimari Melo DeSantana

Keyword(s):

Pain Intensity ◽

Myofascial Pain ◽

Meta Analysis ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Dry Needling

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Poststroke Pain

Seminars in Neurology ◽

10.1055/s-0040-1722641 ◽

2021 ◽

Vol 41 (01) ◽

pp. 067-074

Author(s):

Seoyon Yang ◽

Min Cheol Chang

Keyword(s):

Quality Of Life ◽

Complex Regional Pain Syndrome ◽

Shoulder Pain ◽

Conventional Treatment ◽

Pain Syndrome ◽

Psychological State

AbstractPain is common but often underrecognized after stroke. Poststroke pain (PSP) hinders recovery, impairs quality of life, and is associated with the psychological state of patients with stroke. The most common subtypes of PSP include central PSP, complex regional pain syndrome, shoulder pain, spasticity-related pain, and headache. The pathophysiologies of these PSP subtypes are not yet clearly understood, and PSP is refractory to conventional treatment in many patients. However, recent studies have proposed potential pathophysiologies of PSP subtypes, which may help prioritize therapies that target specific mechanisms.

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576 INTERVENTIONAL REHABILITATION IN PATIENTS WITH SHOULDER PAIN SYNDROME

European Journal of Pain ◽

10.1016/s1090-3801(06)60579-x ◽

2006 ◽

Vol 10 (S1) ◽

pp. S151c-S152

Author(s):

T. Gabrhelik ◽

E. Berta ◽

A. Krobot ◽

M. Mikova

Keyword(s):

Shoulder Pain ◽

Pain Syndrome

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Cost-effectiveness Evaluation of the Inclusion of Dry Needling into an Exercise Program for Subacromial Pain Syndrome: Evidence from a Randomized Clinical Trial

Pain Medicine ◽

10.1093/pm/pny021 ◽

2018 ◽

Vol 19 (12) ◽

pp. 2336-2347 ◽

Cited By ~ 4

Author(s):

José L Arias-Buría ◽

Carlos Martín-Saborido ◽

Joshua Cleland ◽

Shane L Koppenhaver ◽

Gustavo Plaza-Manzano ◽

...

Keyword(s):

Clinical Trial ◽

Cost Effectiveness ◽

Randomized Clinical Trial ◽

Exercise Program ◽

Pain Syndrome ◽

Effectiveness Evaluation ◽

Dry Needling ◽

Subacromial Pain Syndrome

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Changes in Muscle Tone, Function, and Pain in the Chronic Hemiparetic Shoulder after Dry Needling Within or Outside Trigger Points in Stroke Patients: A Crossover Randomized Clinical Trial

Pain Medicine ◽

10.1093/pm/pnaa132 ◽

2020 ◽

Vol 21 (11) ◽

pp. 2939-2947 ◽

Cited By ~ 2

Author(s):

Alma R Hernández-Ortíz ◽

Raquel Ponce-Luceño ◽

Carlos Sáez-Sánchez ◽

Olga García-Sánchez ◽

César Fernández-de-las-Peñas ◽

...

Keyword(s):

Upper Extremity ◽

Shoulder Pain ◽

Repeated Measures ◽

Muscle Tone ◽

Trigger Point ◽

Treatment Session ◽

Dry Needling ◽

Extremity Function ◽

Upper Extremity Function

Abstract Objectives To investigate the effects of applying dry needling into a trigger point (TrP) or non-TrP area in people who have suffered a stroke and to investigate if the effects of dry needling are maintained at six-week follow-up. Methods A controlled, repeated-measures, crossover, double-blinded randomized trial was conducted. Nineteen patients with hemiparetic shoulder pain after a stroke event were randomly assigned to receive a single multimodal treatment session combined with TrP dry needling or non-TrP dry needling. The neuro-rehabilitation session included modulatory interventions targeting the central nervous system. Spasticity (Modified Ashworth Scale), shoulder pain intensity (numerical pain rate scale, 0–10), and upper extremity function (Motor Evaluation Scale for Upper Extremity in Stroke [MESUPES], Reaching Performance Scale [RPS]) were assessed before (baseline) and one, two, three, four, five, and six weeks after the treatment session by a blinded assessor. All participants received both sessions in a randomized order where they were followed up for six weeks before receiving the opposite treatment and then followed up for another six weeks. Results Changes in muscle tone (all P > 0.266) and upper extremity function (MESUPES: F = 0.544, P = 0.465; RPS close task: F = 0.820, P = 0.371; RPS far task: 0.830, P = 0.368) were similar after both interventions at all follow-up periods. The decrease in shoulder pain was higher within the TrP dry needling group as compared with the non-TrP dry needling group, particularly at two and four weeks (P = 0.01). Conclusions The effect of dry needling on muscle tone (spasticity) and upper extremity function is not related to its application in or outside of a TrP area. The effect of dry needling on shoulder pain was slightly superior when applied over a TrP in poststroke people. These effects were maintained six weeks after treatment.

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Comparison of dry needling and trigger point manual therapy in patients with neck and upper back myofascial pain syndrome: a systematic review and meta-analysis

Journal of Manual & Manipulative Therapy ◽

10.1080/10669817.2020.1822618 ◽

2020 ◽

pp. 1-11

Author(s):

Jennalyn Lew ◽

Jennifer Kim ◽

Preeti Nair

Keyword(s):

Systematic Review ◽

Manual Therapy ◽

Myofascial Pain ◽

Trigger Point ◽

Meta Analysis ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Dry Needling

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Subacromial decompression surgery for adults with shoulder pain: a clinical practice guideline

BMJ ◽

10.1136/bmj.l294 ◽

2019 ◽

pp. l294 ◽

Cited By ~ 15

Author(s):

Per Olav Vandvik ◽

Tuomas Lähdeoja ◽

Clare Ardern ◽

Rachelle Buchbinder ◽

Jaydeep Moro ◽

...

Keyword(s):

Shoulder Pain ◽

Decision Aids ◽

Treatment Options ◽

Frozen Shoulder ◽

Pain Syndrome ◽

Decompression Surgery ◽

Subacromial Decompression ◽

Guideline Panel ◽

Common Diagnosis ◽

Patient Reported

AbstractClinical questionDo adults with atraumatic shoulder pain for more than 3 months diagnosed as subacromial pain syndrome (SAPS), also labelled as rotator cuff disease, benefit from subacromial decompression surgery? This guideline builds on to two recent high quality trials of shoulder surgery.Current practiceSAPS is the common diagnosis for shoulder pain with several first line treatment options, including analgesia, exercises, and injections. Surgeons frequently perform arthroscopic subacromial decompression for prolonged symptoms, with guidelines providing conflicting recommendations.RecommendationThe guideline panel makes a strong recommendation against surgery.How this guideline was createdA guideline panel including patients, clinicians, and methodologists produced this recommendation in adherence with standards for trustworthy guidelines and the GRADE system. The recommendation is based on two linked systematic reviews on (a) the benefits and harms of subacromial decompression surgery and (b) the minimally important differences for patient reported outcome measures. Recommendations are made actionable for clinicians and their patients through visual overviews. These provide the relative and absolute benefits and harms of surgery in multilayered evidence summaries and decision aids available in MAGIC (www.magicapp.org) to support shared decisions and adaptation.The evidenceSurgery did not provide important improvements in pain, function, or quality of life compared with placebo surgery or other options. Frozen shoulder may be more common with surgery.Understanding the recommendationThe panel concluded that almost all informed patients would choose to avoid surgery because there is no benefit but there are harms and it is burdensome. Subacromial decompression surgery should not be offered to patients with SAPS. However, there is substantial uncertainty in what alternative treatment is best.

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