scholarly journals Neurophysiological Effects of Dry Needling in Patients with Neck Pain, A Randomized Clinical Trial

Author(s):  
Luis Martín-Sacristán ◽  
Cesar Calvo-Lobo ◽  
Daniel Pecos-Martín ◽  
Josue Fernández-Carnero ◽  
Jose Luis Alonso-Pérez

Abstract The purpose was to determine the efficacy of deep dry needling (DDN) applied on an active myofascial trigger point (MTrP) versus a latent-MTrP versus a non-MTrP location, on pain reduction and cervical disability, in patients with chronic neck pain. A randomized, double-blind clinical trial design was used. A sample of 65 patients was divided into non-MTrP-DDN, active-MTrP-DDN and latent-MTrP-DDN groups. The visual analog scale (VAS), reproduction of the patient’s pain, number of local twitch responses, pressure pain threshold (PPT) and Neck Disability Index (NDI) were assessed before, during and after the intervention and up to 1 month post-intervention. The active-MTrP-DDN-group reduced pain intensity more than non-MTrP-DDN-group after a week and a month (p<0.01). Active-MTrP-DDN-group showed the greatest improvement in tibialis muscle PPT. An association was found with a higher percentage of subjects in whom their neck pain was reproduced when the active-MTrP (77.3%) and the latent-MTrP (81.8%) were treated. The application of DDN on an active-MTrP in the upper trapezius muscle shows greater improvements in pain intensity after one week and one month post-intervention, as well as lesser improvement in PPT in the tibialis muscle, compared to DDN applied in latent-MTrPs or outside of MTrPs in patients with neck pain

2019 ◽  
Vol 37 (3) ◽  
pp. 151-163 ◽  
Author(s):  
Aida Martín-Rodríguez ◽  
Esther Sáez-Olmo ◽  
Daniel Pecos-Martín ◽  
César Calvo-Lobo

Objective: To determine the changes produced by trigger point dry needling (TrP-DN) of sternocleidomastoid in patients with neck pain, and to observe how it might modify cervical motor control (CMC). Design: Single-centre, randomised, double-blinded clinical trial. Setting: Participants were recruited through advertising. The duration of the study was 6 months. Subjects: Thirty-four subjects with non-specific neck pain, aged over 18 years with an active myofascial trigger point in sternocleidomastoid, participated in the study. They were randomly assigned to treatment or control groups. Methods: TrP-DN inside or (1.5 cm) outside of the active myofascial trigger point of sternocleidomastoid. Main outcome measures: CMC, visual analogue scale and cervical range of motion were assessed before treatment, immediately post treatment, and 24 h, 1 week and 1 month after the intervention; the neck disability index was evaluated before treatment and 1 month later. Results: With a confidence interval of 99%, TrP-DN of sternocleidomastoid was associated with a decrease in pain after 1 week and CMC improved 1 month after the intervention (p < 0.001), when compared with baseline measurements, within the experimental group; there were no statistically significant differences between experimental and control groups. Conclusion: The effects of TrP-DN inside and outside of active myofascial trigger points did not differ in this study. Both interventions were associated with a similar temporal effect, specifically a reduction in neck pain at 1 week and an increase CMC at 1 month. However, these findings should be interpreted with caution due to the lack of a contemporaneous untreated control group.


Author(s):  
Juan José Arjona Retamal ◽  
Alejandro Fernández Seijo ◽  
José David Torres Cintas ◽  
Ana I. de-la-Llave-Rincón ◽  
Andrea Caballero Bragado

The INYBI is an instrument used to release the suboccipital myofascial area. There is scarce evidence of its efficacy. A randomized controlled, double-blinded, longitudinal and prospective trial was performed. Ninety-six subjects (aged 29.47 ± 5.16 years) (70 women) with chronic neck pain were randomly assigned to the manual suboccipital inhibition technique (MSIT), instrumental suboccipital inhibition (INYBI) or the INYBI plus upper cervical manipulation technique (INYBI + UCMT) groups and received two sessions with a week interval between them. The Neck Disability Index was used before the first intervention and two weeks after the second intervention. Pre- and post-measurements were taken on both intervention days for pressure pain threshold of the upper trapezius and suboccipital muscles, self-perceived pain and cervical range of motion. In spite of a significant general improvement in time that was found for the three groups for all of the outcome measurements (p < 0.05 in all cases), no between-groups differences were found (p > 0.05 in all cases), with the exception of self-perceived pain for left rotation (p = 0.024), with the MSIT group showing the lower improvement. However, the higher degree of within-group improvements was found for the INYBI + UCMT group. It was concluded that the myofascial release therapy in the suboccipital area is effective in patients with chronic neck pain, either through a manual application or by means of the INYBI tool. Moreover, the addition of craniocervical manipulation achieved the higher within-group improvements, but with no statistical significance.


2019 ◽  
Vol 8 (1) ◽  
pp. 19-24
Author(s):  
Qurat Ul Ain Ausaf

BACKGROUND AND AIM Globally, around one third of population is suffering from persistent neck pain and it is considered as 4th important source of disability in the population. Several treatment protocols are available now a day to facilitate patient recovery. Therefore, the aim of this study is to identify the effects of kinesiotaping in improving neck pain, upper trapezius muscle strength and functional disability. STUDY DESIGN Randomized controlled trial SAMPLE SIZE 68 participants were recruited for the study. METHODOLOGY All participants of age 18-40 years were assessed using assessment Performa. Pain intensity, upper trapezius muscle strength and Neck disability index were measured at baseline and after treatment sessions. Group A comprised of 34 participant, received Kinesiotaping and conventional physical therapy treatment whereas, equal number of participants were recruited in Group B that received upper trapezius stretching and conventional physical therapy. RESULT The study revealed that both interventions (Kinesiotaping and stretching) were effective i.e., <0.05 in improving pain intensity, muscle strength and functional disability in patients with mechanical neck ache but significant improvement were recorded in group treated with kinesiotaping. CONCLUSION The study concluded that both interventions are effective in improving pain intensity, muscle strength and neck disability index but kinesiotaping is more beneficial than stretching among patient with mechanical neck ache.


2020 ◽  
Vol 38 (4) ◽  
pp. 244-254
Author(s):  
Gracia M. Gallego-Sendarrubias ◽  
David Rodríguez-Sanz ◽  
Cesar Calvo-Lobo ◽  
Jose Luis Martín

Objective: Chronic mechanical neck pain is associated with musculoskeletal tissue alterations. Active trigger points in the trapezius and levator scapulae muscles are common in patients with chronic mechanical neck pain. In this study, we compared the effect of dry needling (DN) combined with manual therapy (MT) to sham dry needling (SDN) combined with MT on pain, pain pressure threshold, cervical range of motion and neck disability in patients with chronic mechanical neck pain. Methods: A randomised, single-blind clinical trial was carried out involving 101 participants with chronic mechanical neck pain, divided into an intervention group (DN+MT, n=47) and a control group (SDN+MT, n=54). Participants received two treatment sessions. The intervention group received MT in conjunction with DN of the most mechano-sensitive myofascial trigger point (MTrP). The control group received MT plus SDN. Outcomes measures were: pain intensity (numeric pain rating scale, NPRS), pressure pain threshold (PPT), cervical range of motion (ROM) and neck disability (neck disability index, NDI). Results: This study found that between-group differences in pain intensity were statistically significant (P<0.01). Pain decreased after the first intervention in the DN+MT group (3.47±0.25 points on the NPRS) and even more so after the second intervention (4.76±0.24 points on the NPRS). After 4 weeks, pain intensity differed from baseline by 4.89±0.27 points on the NPRS. Statistically significant differences (P<0.001) in PPT were also found between the intervention group and the control group. After the first intervention, a significant increase in PPT within the DN+MT group (3.09±0.8 kg/cm2) was observed. Cervical ROM also showed highly statistically significant differences. After 4 weeks, a statistically significant reduction (P<0.001) in NDI was observed between the two groups. Conclusion: Our results show that DN+MT is efficacious and significantly better than SDN+MT at reducing pain intensity, PPT, neck disability and cervical ROM in patients with chronic mechanical neck pain. Level of evidence: 1b.


Author(s):  
Eleuterio A. Sánchez Romero ◽  
Tifanny Lim ◽  
Jorge Hugo Villafañe ◽  
Gurvan Boutin ◽  
Victor Riquelme Aguado ◽  
...  

Background: It remains unclear as to whether verbal suggestions and expectancies can influence the perception of post-needling soreness. The aim of this study was to analyze the effects of verbal suggestions on post-needling soreness after dry needling of the trapezius muscle. Methods: This study is a randomized controlled trial including healthy subjects randomly assigned to one of three groups receiving different verbal suggestions about the effects of dry needling and the occurrence of post needling soreness (positive, negative, or neutral). Then, dry needling on a latent trigger point of the upper trapezius muscle was performed and the following outcomes were measured immediately after, 24, 48, and 72 h, and one week after the intervention: post-needling soreness intensity, pressure pain threshold (PPT), temporal summation (TS) and conditioned pain modulation (CPM). Results: Seventy-three consecutive participants were screened and 42 participants (12 men and 30 women, aged: 24 ± 8 years old) were eligible and finished the study protocol. The results showed that verbal suggestion did not influence the perception of post-needling soreness, since there were no differences between groups (p < 0.05) on the intensity of post-needling soreness or tenderness over a one-week follow-up. Moreover, verbal suggestion did not associate with changes in sensorimotor variables of TS and CPM. Conclusions: The induction of different types of expectations through verbal suggestion does not influence the perception of acute pain perceived during the performance of a deep dry needling technique and post-needling pain or soreness after deep dry needling on a latent upper trapezius myofascial trigger point (MTrP).


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