Effectiveness of trigger point dry needling for plantar heel pain: a meta-analysis of seven randomized controlled trials

Background Plantar heel pain can be managed with dry needling of myofascial trigger points; however, there is only poor-quality evidence supporting its use. Objective The purpose of this study was to evaluate the effectiveness of dry needling for plantar heel pain. Design The study was a parallel-group, participant-blinded, randomized controlled trial. Setting The study was conducted in a university health sciences clinic. Patients Study participants were 84 patients with plantar heel pain of at least 1 month's duration. Intervention Participants were randomly assigned to receive real or sham trigger point dry needling. The intervention consisted of 1 treatment per week for 6 weeks. Participants were followed for 12 weeks. Measurements Primary outcome measures included first-step pain, as measured with a visual analog scale (VAS), and foot pain, as measured with the pain subscale of the Foot Health Status Questionnaire (FHSQ). The primary end point for predicting the effectiveness of dry needling for plantar heel pain was 6 weeks. Results At the primary end point, significant effects favored real dry needling over sham dry needling for pain (adjusted mean difference: VAS first-step pain=−14.4 mm, 95% confidence interval [95% CI]=−23.5 to −5.2; FHSQ foot pain=10.0 points, 95% CI=1.0 to 19.1), although the between-group difference was lower than the minimal important difference. The number needed to treat at 6 weeks was 4 (95% CI=2 to 12). The frequency of minor transitory adverse events was significantly greater in the real dry needling group (70 real dry needling appointments [32%] compared with only 1 sham dry needling appointment [<1%]). Limitations It was not possible to blind the therapist. Conclusion Dry needling provided statistically significant reductions in plantar heel pain, but the magnitude of this effect should be considered against the frequency of minor transitory adverse events.

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Effectiveness of trigger point dry needling for plantar heel pain: a randomized controlled trial

Journal of Foot and Ankle Research ◽

10.1186/1757-1146-6-s1-o8 ◽

2013 ◽

Vol 6 (S1) ◽

Cited By ~ 1

Author(s):

Matthew P Cotchett ◽

Karl B Landorf ◽

Shannon E Munteanu

Keyword(s):

Randomized Controlled Trial ◽

Trigger Point ◽

Controlled Trial ◽

Heel Pain ◽

Dry Needling ◽

Randomized Controlled ◽

Plantar Heel Pain

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The Effectiveness of Minimally Invasive Techniques in the Treatment of Patellar Tendinopathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/8706283 ◽

2020 ◽

Vol 2020 ◽

pp. 1-16 ◽

Cited By ~ 1

Author(s):

M. P. López-Royo ◽

M. Ortiz-Lucas ◽

E. M. Gómez-Trullén ◽

P. Herrero

Keyword(s):

Systematic Review ◽

Minimally Invasive ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Patellar Tendinopathy ◽

Controlled Trials ◽

Minimally Invasive Techniques ◽

Dry Needling ◽

Randomized Controlled ◽

Invasive Techniques

The aim was to determine the effectiveness of minimally invasive techniques (MIT) in patients with patellar tendinopathy. Database searches were performed for randomized controlled trials (RCTs) in electronic databases (WOS, Cochrane Central, SportDiscus, and Medline via PubMed and PEDro). The inclusion criteria used were published in English or Spanish and involving adults with patellar tendinopathy (pain on the inferior pole of the patella for a minimum of 3 months), with at least one group receiving MIT. The quality of the relevant RCTs was evaluated using the PEDro scale. The primary outcome was functionality using the VISA-p questionnaire. Secondary outcome was focused on pain. A total of 1164 studies were screened for possible inclusion in our systematic review. Finally, 10 RCTs were included with a total of 326 individuals. Five RCTs were included in the meta-analysis. The quality assessment revealed that all the studies included were considered to possess high methodological quality. All studies analyzing MIT such as platelet-rich plasma (PRP), dry needling, or skin-derived tenocyte-like cells, when combined with exercise, proved to be effective for patellar tendinopathy. Moreover, the PRP technique with doses greater than 4 mL together and combined with an exercise program lasting over 6 weeks obtained better results in functionality and pain than other treatments in the short term. However, in the long term, dry needling and skin-derived tenocyte-like cells are more effective than PRP. Although the infiltration of drugs was effective at posttreatment, these improvements were not maintained over time and may have secondary effects. Although there are no RCTs analyzing the effectiveness of MIT like percutaneous needle electrolysis, there has been an increasing number of publications achieving excellent results in the last years. However, it is necessary to develop RCTs analyzing not only the effect but also comparing the effectiveness between different MIT such as dry needling and percutaneous needle electrolysis.

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