Accuracy and safety of dry needle placement in the piriformis muscle in cadavers

Kearns, Gary; Gilbert, Kerry K.; Allen, Brad; Sizer, Phillip S.; Brismée, Jean‐Michel; Pendergrass, Timothy; Lierly, Micah; York, D.

doi:10.1080/10669817.2017.1346745

Cited by 6 publications

(4 citation statements)

References 32 publications

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“…For example, during DN of the m. piriformis, there is a risk of puncturing the ischiatic nerve, the mm. inclined -the shoulder plexus, the m. dorsalis -the pleura [46].…”

Section: Discussionmentioning

confidence: 99%

Trigger points in medical practice - current therapeutic directions

Wanat¹,

Nowak²,

Świątko³

et al. 2022

Medical Journal of Cell Biology

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Recent scientific evidence suggests that one of the causes of myofascial pain syndromes responsible for the occurrence of chronic headaches, among other things, may be increased or impaired with trigger point therapy. This paper presents the results of a non-systematic literature review on trigger point therapy. The analysis shows a clear increase in scientific interest in invasive trigger point pain treatment techniques. Invasive therapy consists primarily of the use of injections and dry needling. Injections of anesthetics or botulinum toxin are methods that, in addition to their possible therapeutic effect, may carry side effects. In contrast, dry needling does not have a fully scientifically-proven effect. Recent scientific data also indicates that the aforementioned method may have a limited clinical effect. The performed analysis did not demonstrate a significant advantage in invasive techniques over typical non-invasive techniques. It is therefore necessary to design randomized multi-center clinical trials to definitively verify the efficacy of these techniques in the treatment of tension-type trigger point-dependent myofascial pain.

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“…For example, during DN of the m. piriformis, there is a risk of puncturing the ischiatic nerve, the mm. inclined -the shoulder plexus, the m. dorsalis -the pleura [46].…”

Section: Discussionmentioning

confidence: 99%

Trigger points in medical practice - current therapeutic directions

Wanat¹,

Nowak²,

Świątko³

et al. 2022

Medical Journal of Cell Biology

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“…Given that palpation and diagnosis of trigger points in deep muscles are impossible, we could not detect the presence of trigger points in the piriformis muscle with either palpation or ultrasound imaging. In addition, the place of needling in the recommended safest piriformis muscle point is important due to sciatic nerve variation and it is a limitation of the piriformis DN technique . Some authors have suggested that the LTR during DN is an objective measure of needle insertion into the trigger point, especially in deep muscle, the location assumed to have greater therapeutic effect .…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the place of needling in the recommended safest piriformis muscle point is important due to sciatic nerve variation and it is a limitation of the piriformis DN technique. 25,30 Some authors have suggested that the LTR during DN is an objective measure of needle insertion into the trigger point, especially in deep muscle, 31 the location assumed to have greater therapeutic effect. 13,[32][33][34] The results of our study show that 100% of PMS patients elicited an LTR during the DN technique, as visualized by ultrasonography.…”

Section: Pain Intensitymentioning

confidence: 99%

Ultrasound‐guided dry needling decreases pain in patients with piriformis syndrome

et al. 2019

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Introduction Piriformis muscle syndrome (PMS) is a disorder that can lead to symptoms of buttock pain and limited hip‐joint mobility, and may have an impact on quality of life. Methods Thirty‐two patients with PMS were randomized to the treatment group, which included three sessions of ultrasound‐guided dry needling (DN) of the piriformis muscle (n = 16), or a waitlist control group (n = 16). The primary outcome was pain intensity measured on the visual analog scale recorded at baseline and then at 72 hours and 1 week after treatment. Results At 1‐week follow‐up, pain intensity was significantly less in the DN group than in the waitlist control group (−2.16 [−1.01 to −3.32], P = .007) by an amount consistent with clinically meaningful improvement. Discussion The findings suggest that DN resulted in clinically meaningful short‐term improvement in pain intensity of patients with PMS.

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“…MTrPs are identified during palpation and are commonly treated with, but not limited to, trigger point injection, ischemic compression, myofascial release, soft tissue mobilization, and dry needling [2]. While there has been a recent focus on the safety of dry-needling application [3][4][5][6][7] and the potential for adverse events [4][5][6]8], one area that seems to be missing is context. Most papers focus on proper and deep knowledge of anatomy for safe application of dry needling [4,5].…”

Section: Introductionmentioning

confidence: 99%

New perspectives on dry needling following a medical model: are we screening our patients sufficiently?

Kearns

Fernández‐de‐las‐Peñas

Brismée

et al. 2019

Journal of Manual & Manipulative Therapy

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Myofascial trigger points are not an isolated neuromusculoskeletal phenomenon and have been implicated in systemic, visceral, and metabolic pathology, as a side effect of some medications and in the presence of psychological risk factors. This complexity can complicate adequate screening of patients prior to choosing dry needling as a treatment intervention. Regardless of whether clinicians practice in a direct access setting, they should be cognizant of medical conditions, comorbidities, and risk factors that will influence clinical decisions for dry-needling appropriateness, technique chosen, and potential adverse responses to treatment. Of primary concern are conditions that can either manifest with myalgia and/or myopathy or masquerade as a more common musculoskeletal condition. This clinical commentary reviews system-specific considerations and other common disorders that should be screened for and discusses not only whether dry needling is appropriate but comments on technique and dosage considerations when initiating dry needling.

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Accuracy and safety of dry needle placement in the piriformis muscle in cadavers

Abstract: 2c.

Cited by 6 publications

References 32 publications

Trigger points in medical practice - current therapeutic directions

Trigger points in medical practice - current therapeutic directions

Ultrasound‐guided dry needling decreases pain in patients with piriformis syndrome

New perspectives on dry needling following a medical model: are we screening our patients sufficiently?

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