Effectiveness between Dry Needling and Ischemic Compression in the Triceps Surae Latent Myofascial Trigger Points of Triathletes on Pressure Pain Threshold and Thermography: A Single Blinded Randomized Clinical Trial

Background: Deep dry needling (DDN) and ischemic compression technic (ICT) may be considered as interventions used for the treatment of Myofascial Pain Syndrome (MPS) in latent myofascial trigger points (MTrPs). The immediate effectiveness of both DDN and ICT on pressure pain threshold (PPT) and skin temperature of the latent MTrPs of the triceps surae has not yet been determined, especially in athletes due to their treatment requirements during training and competition. Objective: To compare the immediate efficacy between DDN and ICT in the latent MTrPs of triathletes considering PPT and thermography measurements. Method: A total sample of 34 triathletes was divided into two groups: DDN and ICT. The triathletes only received a treatment session of DDN (n = 17) or ICT (n = 17). PPT and skin temperature of the selected latent MTrPs were assessed before and after treatment. Results: Statistically significant differences between both groups were shown after treatment, showing a PPT reduction (p < 0.05) in the DDN group, while PPT values were maintained in the ICT group. There were not statistically significant differences (p > 0.05) for thermographic values before and treatment for both interventions. Conclusions: Findings of this study suggested that ICT could be more advisable than DDN regarding latent MTrPs local mechanosensitivity immediately after treatment due to the requirements of training and competition in athletes’ population. Nevertheless, further studies comparing both interventions in the long term should be carried out in this specific population due to the possible influence of delayed onset muscle soreness and muscle damage on PPT and thermography values secondary to the high level of training and competition.

Download Full-text

Percutaneous Fascia Release for Treating Chronic Recurrent Gluteal Myofascial Pain—A Pilot Study of a New Technique

Rehabilitation Process and Outcome ◽

10.4137/rpo.s30483 ◽

2015 ◽

Vol 4 ◽

pp. RPO.S30483 ◽

Cited By ~ 1

Author(s):

Hsin-Shui Chen ◽

Ming-Ta Lin ◽

Chang-Zern Hong ◽

Yueh-Ling Hsieh ◽

Li-Wei Chou

Keyword(s):

Pilot Study ◽

Pain Intensity ◽

Pain Threshold ◽

Myofascial Pain ◽

Pressure Pain Threshold ◽

Small Sample ◽

Myofascial Trigger Points ◽

Pressure Pain ◽

Hip Abduction ◽

Abduction Strength

Objective To investigate the therapeutic effectiveness of percutaneous fascia release to treat chronic recurrent gluteal myofascial pain related to recurrent tendonitis or bursitis at the attachment sites. Methods Five patients (three males, two females; aged 48.6 ± 8.9 years) with myofascial trigger points in the gluteus medius muscle were treated. Outcome measures, including pain intensity, pressure pain threshold, and the relative strength of hip abduction, were assessed before, immediately after, and six months after the treatment. The data measured before and after treatment (different times) on visual analog scale, pressure pain threshold, and relative hip abduction strength were analyzed by Wilcoxon signed-rank test and paired t-test, respectively, for the comparisons between time points. Results Reduction in pain intensity and increase in the pressure pain threshold and the relative hip abduction strength were found in all five patients after treatment when compared with those of before treatment ( P < 0.05). Moreover, all of these improvements existed for at least six months ( P > 0.05). Conclusions Percutaneous fascia release of gluteal muscle insertion sites can be used to treat chronic gluteal pain related to subtrochanteric bursitis to avoid recurrence, if other treatment cannot control the recurrence, although this was demonstrated only on a small sample size without control and blind assessment in the pilot study.

Download Full-text

Percutaneous Soft Tissue Release for Treating Chronic Recurrent Myofascial Pain Associated with Lateral Epicondylitis: 6 Case Studies

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2012/142941 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Ming-Ta Lin ◽

Li-Wei Chou ◽

Hsin-Shui Chen ◽

Mu-Jung Kao

Keyword(s):

Soft Tissue ◽

Pain Intensity ◽

Pain Threshold ◽

Myofascial Pain ◽

Pressure Pain Threshold ◽

Lateral Epicondylitis ◽

Soft Tissue Release ◽

Recurrent Pain ◽

Myofascial Trigger Points ◽

Pressure Pain

Objective. The purpose of this pilot study is to investigate the effectiveness of the percutaneous soft tissue release for the treatment of recurrent myofascial pain in the forearm due to recurrent lateral epicondylitis.Methods. Six patients with chronic recurrent pain in the forearm with myofascial trigger points (MTrPs) due to chronic lateral epicondylitis were treated with percutaneous soft tissue release of Lin’s technique. Pain intensity (measured with a numerical pain rating scale), pressure pain threshold (measured with a pressure algometer), and grasping strength (measured with a hand dynamometer) were assessed before, immediately after, and 3 months and 12 months after the treatment.Results. For every individual case, the pain intensity was significantly reduced(P<0.01)and the pressure pain threshold and the grasping strength were significantly increased(P<0.01)immediately after the treatment. This significant effectiveness lasts for at least one year.Conclusions. It is suggested that percutaneous soft tissue release can be used for treating chronic recurrent lateral epicondylitis to avoid recurrence, if other treatment, such as oral anti-inflammatory medicine, physical therapy, or local steroid injection, cannot control the recurrent pain.

Download Full-text

Evaluation of the Analgesic Effect of Combination Therapy on Chronic Plantar Pain Through the Myofascial Trigger Points Approach

Journal of the American Podiatric Medical Association ◽

10.7547/16-038 ◽

2018 ◽

Vol 108 (1) ◽

pp. 27-32 ◽

Cited By ~ 2

Author(s):

Rocío Melero-Suárez ◽

José Antonio Sánchez-Santos ◽

Gabriel Domínguez-Maldonado

Keyword(s):

Combination Therapy ◽

Analgesic Effect ◽

Myofascial Pain ◽

Pressure Pain Threshold ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Adductor Muscle ◽

Rank Test ◽

Myofascial Trigger Points

Background: Closely related pathologic disorders sometimes manifest with the same symptoms, making for a complex differential diagnosis. This is the situation in plantar fasciitis (PF) and myofascial pain syndrome (MPS) with myofascial trigger points (MTPs) in the sole of the foot. This research assessed the analgesic effect on plantar pain of combination therapy with interferential current stimulation therapy (ICST), treating MTPs in the great toe adductor muscle and the short flexor muscles of the toes in patients whose diagnosis was compatible with PF or MPS. Methods: This study included 22 feet of 17 patients with a diagnosis compatible with PF or MPS with MTP. Participants received combination therapy with ICST for 15 sessions, and the decrease in pain was measured with an algometer and the visual analog scale. Both measurements were taken before and after every fifth session. The pressure pain threshold (PPT) results obtained with the Student t test and the pain intensity perception (PIP) results obtained with the Wilcoxon signed rank test were analyzed by comparing the measurements taken before the treatment and after the fifth, tenth, and 15th sessions. Results: The decrease in PIP was significant after the fifth, tenth, and 15th sessions (P < .001). The increase in PPT was also significant after the fifth (P = .010), tenth (P = .023), and 15th (P = .001) sessions (P < .05). Conclusions: The suggested combination therapy of ultrasound with ICST is clinically significant for reducing plantar pain after 15 treatment sessions, with a 6.5-point reduction in mean PIP and a 4.6-point increase in PPT.

Download Full-text

Effectiveness of dry needling on the local pressure pain threshold in patients with masticatory myofascial pain. Systematic review and preliminary clinical trial

CRANIO® ◽

10.1080/08869634.2019.1588518 ◽

2019 ◽

pp. 1-9 ◽

Cited By ~ 5

Author(s):

Ricardo De Souza Tesch ◽

Leonora Cristina Da Silva Parente Macedo ◽

Fabrício Sanches Fernandes ◽

Gilberto Senechal De Goffredo Filho ◽

Cristiana Pessoa De Queiroz Faria Goes

Keyword(s):

Systematic Review ◽

Clinical Trial ◽

Pain Threshold ◽

Myofascial Pain ◽

Pressure Pain Threshold ◽

Dry Needling ◽

Local Pressure ◽

Pressure Pain ◽

Preliminary Clinical Trial

Download Full-text

Probable Mechanisms of Needling Therapies for Myofascial Pain Control

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2012/705327 ◽

2012 ◽

Vol 2012 ◽

pp. 1-11 ◽

Cited By ~ 36

Author(s):

Li-Wei Chou ◽

Mu-Jung Kao ◽

Jaung-Geng Lin

Keyword(s):

Animal Studies ◽

Myofascial Pain ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Dry Needling ◽

Myofascial Trigger Points ◽

Appropriate Treatment ◽

Clinical Pain ◽

Hormonal System

Myofascial pain syndrome (MPS) has been defined as a regional pain syndrome characterized by muscle pain caused by myofascial trigger points (MTrPs) clinically. MTrP is defined as the hyperirritable spot in a palpable taut band of skeletal muscle fibers. Appropriate treatment to MTrPs can effectively relieve the clinical pain of MPS. Needling therapies, such as MTrP injection, dry needling, or acupuncture (AcP) can effectively eliminate pain immediately. AcP is probably the first reported technique in treating MPS patients with dry needling based on the Traditional Chinese Medicine (TCM) theory. The possible mechanism of AcP analgesia were studied and published in recent decades. The analgesic effect of AcP is hypothesized to be related to immune, hormonal, and nervous systems. Compared to slow-acting hormonal system, nervous system acts in a faster manner. Given these complexities, AcP analgesia cannot be explained by any single mechanism. There are several principles for selection of acupoints based on the TCM principles: “Ah-Shi” point, proximal or remote acupoints on the meridian, and extra-meridian acupoints. Correlations between acupoints and MTrPs are discussed. Some clinical and animal studies of remote AcP for MTrPs and the possible mechanisms of remote effectiveness are reviewed and discussed.

Download Full-text

Clinical criteria for the application of dry needling in myofascial pain Syndrome: An expert consensus document and a cross-sectional study among physical therapists

Revista Fisioterapia Invasiva ◽

10.1055/s-0039-3402788 ◽

2019 ◽

Vol 02 (02) ◽

pp. 050-054

Author(s):

Nicolas Secorro ◽

Rafael Guerra ◽

Xavi Labraca ◽

Marc Lari ◽

Daniel Pecos ◽

...

Keyword(s):

Physical Therapy ◽

Myofascial Pain ◽

Panel Discussion ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Dry Needling ◽

Cross Sectional ◽

Myofascial Trigger Points ◽

Clinical Criteria

AbstractPresently, there is no clear consensus on the essential and confirmatory criteria which should govern the application of dry needling (DN) in the treatment of myofascial trigger points. The aim of this study was to generate a consensus on these criteria, via a panel discussion with DN experts which took place at the International Conference of Invasive Physical Therapy held in 2018, including the opinion of the attendees who participated in a live survey on the subject at the conference via an app. The results obtained reveal discrepancies regarding confirmatory criteria such as the elicitation of referred pain; nonetheless, consensus exists on the suitability of the application of individualized and personalized DN treatment and the combination of treatment with other intervention approaches in physical therapy, with the use of ultrasound when required to support a safer clinical practice.

Download Full-text

The role of a dry needling technique in pain reduction

Journal of Health Sciences ◽

10.17532/jhsci.2018.610 ◽

2018 ◽

Vol 8 (3) ◽

pp. 128-139

Author(s):

Eldad Kaljić ◽

Namik Trtak ◽

Dijana Avdić ◽

Samir Bojičić ◽

Bakir Katana ◽

...

Keyword(s):

Systematic Review ◽

Pain Intensity ◽

Musculoskeletal Pain ◽

Myofascial Pain ◽

Pain Syndrome ◽

Trigger Points ◽

Pain Reduction ◽

Dry Needling ◽

Myofascial Trigger Points ◽

Randomized Controlled Studies

Introduction: Dry needling is a therapeutic procedure using the insertion of thin needles through the skin into myofascial trigger points (MTrPs), muscular or connective tissue with the aim to reduce pain intensity. The objective of this systematic review is to analyze the literature for the efficacy of the dry needle technique in pain reduction in conditions of musculoskeletal pain caused by MTrPs. Reference Sources: Web of Science, Scopus and EBSCOhost database were searched for studies and e-books published from January 2010 to December 2018. Studies Selection: We included randomized controlled studies, prospective and longitudinal studies, and case studies which analyzed the efficacy of dry needling for musculoskeletal pain reduction. Data Extraction Method: The studies, which satisfied criteria for inclusion were further analyzed. The primary instrument of the evaluation was pain intensity analyses. Results: Dry needling treatment is efficient in pain intensity reduction in patients who suffer musculoskeletal pain and is more efficient compared to sham dry needling treatment. In addition, different techniques of dry needling are efficient in the treatment of myofascial pain syndrome. Conclusion: Based on systematic review of the literature, dry needling, independently or as an addition to other intervention, is recommended for treatment of musculoskeletal pain conditions caused by myofascial trigger points. Various techniques of dry needling treatment are almost equally efficient in myofascial pain intensity reduction.

Download Full-text

Effect of Physical Exercise Programs on Myofascial Trigger Points–Related Dysfunctions: A Systematic Review and Meta-analysis

Pain Medicine ◽

10.1093/pm/pnaa253 ◽

2020 ◽

Vol 21 (11) ◽

pp. 2986-2996

Author(s):

María José Guzmán-Pavón ◽

Iván Cavero-Redondo ◽

Vicente Martínez-Vizcaíno ◽

Rubén Fernández-Rodríguez ◽

Sara Reina-Gutierrez ◽

...

Keyword(s):

Physical Exercise ◽

Pain Intensity ◽

Range Of Motion ◽

Pain Threshold ◽

Meta Analysis ◽

Pressure Pain Threshold ◽

Trigger Points ◽

Exercise Programs ◽

Myofascial Trigger Points ◽

Pressure Pain

Abstract Objective Myofascial pain syndrome is one of the primary causes of health care visits. In recent years, physical exercise programs have been developed for the treatment of myofascial trigger points, but their effect on different outcomes has not been clarified. Thus, this study aimed to assess the effect of physical exercise programs on myofascial trigger points. Methods A systematic search was conducted in Pubmed, Web of Science, and Scopus. Articles analyzing the effect of physical exercise programs on pain intensity, pressure pain threshold, range of motion, and disability were included. Risk of bias was assessed using the Cochrane RoB2 tool. The DerSimonian-Laird method was used to compute the pooled effect sizes (ES) and their 95% confidence interval (95% CI) for pain intensity, pressure pain threshold, range of motion, and disability. Results A total of 24 randomized controlled trials were included in this systematic review and meta-analysis. The pooled ES were –0.47 (95% CI = –0.61 to –0.33) for pain intensity, 0.63 (95% CI = 0.31 to 0.95) for pressure pain threshold, 0.43 (95% CI = 0.24 to 0.62) for range of motion, and –0.18 (95% CI = –0.45 to 0.10) for disability. Conclusions Physical exercise programs may be an effective approach in the treatment of pain intensity, pressure pain threshold, and range of motion among patients with myofascial trigger points.

Download Full-text

A Proposed Experimental Model of Myofascial Trigger Points in Human Muscle after Slow Eccentric Exercise

Acupuncture in Medicine ◽

10.1136/aim.22.1.2 ◽

2004 ◽

Vol 22 (1) ◽

pp. 2-13 ◽

Cited By ~ 60

Author(s):

Kazunori Itoh ◽

Kaoru Okada ◽

Kenji Kawakita

Keyword(s):

Experimental Model ◽

Eccentric Exercise ◽

Pain Threshold ◽

Pressure Pain Threshold ◽

Trigger Points ◽

Emg Activity ◽

Acupuncture Points ◽

Myofascial Trigger Points ◽

Pressure Pain ◽

Pressure Pain Thresholds

Background The purpose of this study was to develop an experimental model of myofascial trigger points to investigate their pathophysiology. Methods Fifteen healthy volunteers who gave informed consent underwent repetitive eccentric exercise of the third finger of one hand (0.1Hz repetitions, three sets at five minute intervals) until exhaustion. Physical examination, pressure pain threshold, and electrical pain threshold of the skin, fascia and muscle were measured immediately afterwards and for seven days. Needle electromyogram (EMG) was also recorded in a subgroup of participants. Results Pressure pain thresholds decreased to a minimum on the second day after the exercise, then gradually returned to baseline values by the seventh day. On the second day, a ropy band was palpated in the exercised forearm muscle and the electrical pain threshold of the fascia at the palpable band was the lowest among the measured loci and tissues. Needle EMG activity accompanied with dull pain sensation was recorded only when the electrode was located on or near the fascia of the palpable band on the second day of exercise. Conclusion These results suggest that eccentric exercise may yield a useful model for the investigation of the myofascial trigger points and/or acupuncture points. The sensitised nociceptors at the fascia of the palpable band might be a possible candidate for the localised tender region.

Download Full-text

Therapeutic Effects of Dry Needling in Patients with Upper Trapezius Myofascial Trigger Points

Acupuncture in Medicine ◽

10.1136/acupmed-2016-011082 ◽

2017 ◽

Vol 35 (2) ◽

pp. 85-92 ◽

Cited By ~ 6

Author(s):

Maryam Abbaszadeh-Amirdehi ◽

Noureddin Nakhostin Ansari ◽

Soofia Naghdi ◽

Gholamreza Olyaei ◽

Mohammad Reza Nourbakhsh

Keyword(s):

Healthy Volunteers ◽

Myofascial Pain ◽

Pressure Pain Threshold ◽

Trigger Points ◽

Therapeutic Effects ◽

Clinical Effects ◽

Dry Needling ◽

Post Intervention ◽

Myofascial Trigger Points ◽

Upper Trapezius

Background Active myofascial trigger points (MTrPs) are major pain generators in myofascial pain syndrome. Dry needling (DN) is an effective method for the treatment of MTrPs. Objective To assess the immediate neurophysiological and clinical effects of DN in patients with upper trapezius MTrPs. Methods This was a prospective, clinical trial study of 20 patients with upper trapezius MTrPs and 20 healthy volunteers (matched for height, weight, body mass index and age), all of whom received one session of DN. Primary outcome measures were neuromuscular junction response (NMJR) and sympathetic skin response (SSR). Secondary outcomes were pain intensity (PI) and pressure pain threshold (PPT). Data were collected at baseline and immediately post-intervention. Results At baseline, SSR amplitude was higher in patients versus healthy volunteers (p<0.003). With respect to NMJR, a clinically abnormal increment and normal reduction was observed in patients and healthy volunteers, respectively. Moreover, PPT of patients was less than healthy volunteers (p<0.0001). After DN, SSR amplitude decreased significantly in patients (p<0.01), but did not change in healthy volunteers. A clinically important reduction in the NMJR of patients and increment in healthy volunteers was demonstrated after DN. PPT increased after DN in patients, but decreased in healthy volunteers (p<0.0001). PI improved after DN in patients (p<0.001). Conclusions The results of this study showed that one session of DN targeting active MTrPs appears to reduce hyperactivity of the sympathetic nervous system and irritability of the motor endplate. DN seems effective at improving symptoms and deactivating active MTrPs, although further research is needed. Trial registration number IRCT20130316128.

Download Full-text