scholarly journals Effectiveness of Dry Needling for Myofascial Trigger Points Associated with Neck Pain Symptoms: An Updated Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (10) ◽  
pp. 3300
Author(s):  
Marcos J. Navarro-Santana ◽  
Jorge Sanchez-Infante ◽  
César Fernández-de-las-Peñas ◽  
Joshua A. Cleland ◽  
Patricia Martín-Casas ◽  
...  
Keyword(s):  
Neck Pain ◽  
Range Of Motion ◽  
Trigger Points ◽  
Dry Needling ◽  
Short Term ◽  
Pressure Pain ◽  
Cervical Range Of Motion ◽  
Pressure Pain Thresholds ◽  
Mean Differences ◽  
Pain Symptoms

Our aim was to evaluate the effect of dry needling alone as compared to sham needling, no intervention, or other physical interventions applied over trigger points (TrPs) related with neck pain symptoms. Randomized controlled trials including one group receiving dry needling for TrPs associated with neck pain were identified in electronic databases. Outcomes included pain intensity, pain-related disability, pressure pain thresholds, and cervical range of motion. The Cochrane risk of bias tool and the Physiotherapy Evidence Database (PEDro) score were used to assessed risk of bias (RoB) and methodological quality of the trials. The quality of evidence was assessed by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Between-groups mean differences (MD) and standardized mean differences (SMD) were calculated (3) Twenty-eight trials were finally included. Dry needling reduced pain immediately after (MD −1.53, 95% CI −2.29 to −0.76) and at short-term (MD −2.31, 95% CI −3.64 to −0.99) when compared with sham/placebo/waiting list/other form of dry needling and, also, at short-term (MD −0.51, 95% CI −0.95 to −0.06) compared with manual therapy. No differences in comparison with other physical therapy interventions were observed. An effect on pain-related disability at the short-term was found when comparing dry needing with sham/placebo/waiting list/other form of dry needling (SMD −0.87, 95% CI −1.60 to −0.14) but not with manual therapy or other interventions. Dry needling was effective for improving pressure pain thresholds immediately after the intervention (MD 55.48 kPa, 95% CI 27.03 to 83.93). No effect on cervical range of motion of dry needling against either comparative group was found. No between-treatment effect was observed in any outcome at mid-term. Low to moderate evidence suggests that dry needling can be effective for improving pain intensity and pain-related disability in individuals with neck pain symptoms associated with TrPs at the short-term. No significant effects on pressure pain sensitivity or cervical range of motion were observed.

scholarly journals Is Dry Needling Effective When Combined with Other Therapies for Myofascial Trigger Points Associated with Neck Pain Symptoms? A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-24
Author(s):  
César Fernández-De-Las-Peñas ◽  
Gustavo Plaza-Manzano ◽  
Jorge Sanchez-Infante ◽  
Guido F Gómez-Chiguano ◽  
Joshua A Cleland ◽  
...  
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Range Of Motion ◽  
Dry Needling ◽  
Short Term ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Cervical Range Of Motion ◽  
Pressure Pain Thresholds

Objective. To evaluate the effects of combining dry needling with other physical therapy interventions versus the application of the other interventions or dry needling alone applied over trigger points (TrPs) associated to neck pain. Databases and Data Treatment. Electronic databases were searched for randomized controlled trials where at least one group received dry needling combined with other interventions for TrPs associated with neck pain. Outcomes included pain intensity, pain-related disability, pressure pain thresholds, and cervical range of motion. The risk of bias (RoB) was assessed using the Cochrane risk of bias tool, methodological quality was assessed with PEDro score, and the quality of evidence was assessed by using the GRADE approach. Between-groups mean differences (MD) and standardized mean difference (SMD) were calculated. Results. Eight trials were included. Dry needling combined with other interventions reduced pain intensity at short-term (SMD −1.46, 95% CI −2.25 to −0.67) and midterm (SMD −0.38, 95% CI −0.74 to −0.03) but not immediately after or at long-term compared with the other interventions alone. A small effect on pain-related disability was observed at short-term (SMD −0.45, 95% CI −0.87 to −0.03) but not at midterm or long-term. The inclusion of dry needling was also effective for improving pressure pain thresholds only at short-term (MD 112.02 kPa, 95% CI 27.99 to 196.06). No significant effects on cervical range of motion or pain catastrophism were observed. Conclusion. Low-to-moderate evidence suggests a positive effect to the combination of dry needling with other interventions for improving pain intensity, pain-related disability, pressure pain thresholds, and cervical range of motion in people with neck pain associated with TrPs at short-term. No midterm or long-term effects were observed.

scholarly journals Effects of Dry Needling of Latent Trigger Points on Viscoelastic and Muscular Contractile Properties: Preliminary Results of a Randomized Within-Participant Clinical Trial

2021 ◽  
Vol 10 (17) ◽  
pp. 3848
Author(s):  
Albert Pérez-Bellmunt ◽  
Oriol Casasayas-Cos ◽  
Carlos López-de-Celis ◽  
Jacobo Rodríguez-Sanz ◽  
Jorge Rodríguez-Jiménez ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Range Of Motion ◽  
Pain Sensitivity ◽  
Gastrocnemius Muscle ◽  
Trigger Points ◽  
Neuromuscular Function ◽  
Medial Gastrocnemius ◽  
Single Session ◽  
Dry Needling ◽  
Pressure Pain

This study aimed to evaluate changes in neuromuscular function and pain perception in latent trigger points (TrPs) in the gastrocnemius muscle after a single session of dry needling. A randomized within-participant clinical trial was conducted. Fifty volunteers with latent TrPs in the gastrocnemius muscles were explored. Each extremity was randomly assigned to a control or experimental (dry needling) group. Viscoelastic parameters and contractile properties were analyzed by tensiomyography. Ankle dorsiflexion range of motion was assessed with the lunge test. Pressure pain thresholds (PPT) and pain perceived were also analyzed. The results observed that three viscoelastic proprieties (myotonometry) showed significant differences in favor of the experimental extremity in the lateral gastrocnemius: stiffness (p = 0.02), relaxation (p = 0.045), and creep (p = 0.03), but not in the medial gastrocnemius. No changes in tensiomyography outcomes were found. The control extremity showed a higher increase in PPTs (i.e., decrease in pressure pain sensitivity) than the experimental extremity (p = 0.03). No significant effects for range of motion or strength were observed. In general, gender did not influence the effects of dry needling over latent TrPs in the gastrocnemius muscle. In conclusion, a single session of dry needling was able to change some parameters of neuromuscular function, such as muscle tone, relaxation, pressure pain sensitivity, and creep in the lateral (but not medial) gastrocnemius but did not improve strength or range of motion.

scholarly journals Short-Term Effects of PENS versus Dry Needling in Subjects with Unilateral Mechanical Neck Pain and Active Myofascial Trigger Points in Levator Scapulae Muscle: A Randomized Controlled Trial

2020 ◽  
Vol 9 (6) ◽  
pp. 1665 ◽  
Author(s):  
Santiago Garcia-de-Miguel ◽  
Daniel Pecos-Martin ◽  
Tamara Larroca-Sanz ◽  
Beatriz Sanz-de-Vicente ◽  
Laura Garcia-Montes ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Neck Pain ◽  
Pain Intensity ◽  
Controlled Trial ◽  
Trigger Points ◽  
Mean Difference ◽  
Dry Needling ◽  
Short Term ◽  
Myofascial Trigger Points ◽  
Randomized Controlled

Procedures such as dry needling (DN) or percutaneous electrical nerve stimulation (PENS) are commonly proposed for the treatment of myofascial trigger points (MTrP). The aim of the present study is to investigate if PENS is more effective than DN in the short term in subjects with mechanical neck pain. This was an evaluator-blinded randomized controlled trial. Subjects were recruited through announcements and randomly allocated into DN or PENS groups. Pain intensity, disability, pressure pain threshold (PPT), range of motion (ROM), and side-bending strength were measured. The analyses included mixed-model analyses of variance and pairwise comparisons with Bonferroni correction. The final sample was composed of 44 subjects (22 per group). Both groups showed improvements in pain intensity (ηp2 = 0.62; p < 0.01), disability (ηp2 = 0.74; p < 0.01), PPT (ηp2 = 0.79; p < 0.01), and strength (ηp2 = 0.37; p < 0.01). The PENS group showed greater improvements in disability (mean difference, 3.27; 95% CI, 0.27–6.27) and PPT (mean difference, 0.88–1.35; p < 0.01). Mixed results were obtained for ROM. PENS seems to produce greater improvements in PPT and disability in the short term.

Effects of Deep Cervical Flexor Training on Pressure Pain Thresholds Over Myofascial Trigger Points in Patients With Chronic Neck Pain

2013 ◽  
Vol 36 (9) ◽  
pp. 604-611 ◽  
Author(s):  
Enrique Lluch ◽  
Maria Dolores Arguisuelas ◽  
Pablo S. Coloma ◽  
Francisco Palma ◽  
Alejandro Rey ◽  
...  
Keyword(s):  
Neck Pain ◽  
Chronic Neck Pain ◽  
Trigger Points ◽  
Myofascial Trigger Points ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds

Widespread Pressure Pain Hypersensitivity, Health History, and Trigger Points in Patients with Chronic Neck Pain: A Preliminary Study

Pain Medicine ◽  
2019 ◽  
Vol 20 (12) ◽  
pp. 2516-2527 ◽  
Author(s):  
Matteo Castaldo ◽  
Antonella Catena ◽  
César Fernández-de-las-Peñas ◽  
Lars Arendt-Nielsen
Keyword(s):  
Neck Pain ◽  
Chronic Neck Pain ◽  
Trigger Points ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pain Hypersensitivity ◽  
Health History ◽  
Upper Trapezius ◽  
Pressure Pain Thresholds ◽  
Pain Patients

Abstract Background Pain sensitivity in chronic neck pain patients may be influenced by health conditions related to higher levels of widespread pressure pain hypersensitivity (sensitization). Trigger points have also been reported to play a role in the sensitization process. Objectives To investigate the association between pressure pain thresholds, trigger points, and health conditions in patients with chronic neck pain. Design Original research, preliminary study. Setting A private clinic. Subjects Thirty-four chronic mechanical neck pain patients and 34 chronic whiplash-associated neck pain patients, giving a final sample of 68 chronic neck pain patients. Methods Patients underwent an assessment of pressure pain thresholds over the upper trapezius, extensor carpi radialis longus, and tibialis anterior muscles and were screened for the presence of trigger points in the upper trapezius muscle. Further, information about health history conditions was obtained and collected in a form. Results Significantly negative correlations between all pressure pain thresholds and duration of health history conditions were found (all P &lt; 0.02). Significantly lower pressure pain thresholds (all P &lt; 0.01) were found in patients with active trigger points as compared with those with latent trigger points. Conclusion Widespread pressure pain hypersensitivity was associated with duration of health history conditions, suggesting that long-lasting health complaints may act as a triggering/perpetuating factor, driving sensitization in individuals with chronic neck pain. Active trigger points may be associated with higher widespread pressure hypersensitivity.

Effects of trigger point dry needling on lateral epicondylalgia of musculoskeletal origin: a systematic review and meta-analysis

2020 ◽  
Vol 34 (11) ◽  
pp. 1327-1340 ◽  
Author(s):  
Marcos J Navarro-Santana ◽  
Jorge Sanchez-Infante ◽  
Guido F Gómez-Chiguano ◽  
Joshua A Cleland ◽  
Ibai López-de-Uralde-Villanueva ◽  
...  
Keyword(s):  
Pain Sensitivity ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Dry Needling ◽  
Short Term ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Lateral Epicondylalgia ◽  
Comparative Group

Objective: This meta-analysis evaluated the effect of dry needling alone or combined with other treatment interventions on pain, related-disability, pressure pain sensitivity, and strength in people with lateral epicondylalgia of musculoskeletal origin. Data Sources: MEDLINE, CINAHL, PubMed, PEDro, Cochrane Library, SCOPUS and Web of Science databases from their inception to 5 April 2020. Review Methods: Randomized controlled trials collecting outcomes on pain, related-disability, pressure pain thresholds, or strength where one group received dry needling for lateral epicondylalgia of musculoskeletal origin. The risk of bias was assessed by the Cochrane Guidelines, methodological quality was assessed with the PEDro score, and the quality of evidence by using the GRADE approach. Results: Seven studies including 320 patients with lateral epicondylalgia were included. The meta-analysis found that dry needling reduced pain intensity (SMD ‒1.13, 95%CI ‒1.64 to ‒0.62) and related-disability (SMD ‒2.17, 95%CI ‒3.34 to ‒1.01) with large effect sizes compared to a comparative group. Dry needling also increased pressure pain thresholds with a large effect size (SMD 0.98, 95%CI 0.30 to 1.67) and grip strength with a small size effect (SMD 0.48, 95%CI 0.16 to 0.81) when compared to a comparative group. The most significant effect was at short-term. The risk of bias was generally low, but the heterogenicity of the results downgraded the evidence level. Conclusion: Low to moderate evidence suggests a positive effect of dry needling for pain, pain-related disability, pressure pain sensitivity and strength at short-term in patients with lateral epicondylalgia of musculoskeletal origin. Level of Evidence: Therapy, level 1a. Registration number: OSF Registry - https://doi.org/10.17605/OSF.IO/ZY3E8

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