Botulinum Toxin, Lidocaine, and Dry-Needling Injections in Patients with Myofascial Pain and Headaches

Venâncio, Roberta de Abreu; Junior, F G P Alencar; Zamperini, Camila Andrade

doi:10.1179/crn.2009.008

Cited by 88 publications

(36 citation statements)

References 41 publications

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“…muscle tissue) and non-TrP structures (i.e. neural and connective tissues) in combination, or non-TrP structures alone, is effective for the reduction of pain and disability in knee osteoarthritis,50–50–51,81–83,85–90,166–168 hip osteoarthritis,53,91–94 piriformis syndrome,60 carpal tunnel syndrome,36,37,40,41,44,45,47 migraine,95–101 tension type headache,97,98,102 temporomandibular disorder,59,67,103–107 shoulder pain,108–110 neck pain,23,24,29,35,61,63–65,80,111–114 low back pain,4,5,19,20,66,69,115–125 and plantar fasciitis 48,49,54,56,126,127…”

Section: Trp Needling Is Only One Kind Of Dry Needlingmentioning

confidence: 99%

“…While several studies29,35,59,63,64,67,102,104,182,183 have demonstrated immediate and/or short-term improvements in pain and/or disability following ‘in-an-out’ techniques, to date, there are no high-quality long-term trials23,24 to support the practice of immediately removing the needles after pricking TrPs or eliciting LTRs; therefore, this practice should be questioned.…”

Section: Multiple Needles Should Be Left In Situ For 10–30 Minutesmentioning

confidence: 99%

See 1 more Smart Citation

Dry needling: a literature review with implications for clinical practice guidelines

Dunning¹,

Butts

Mourad³

et al. 2014

Physical Therapy Reviews

241

210

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Background:Wet needling uses hollow-bore needles to deliver corticosteroids, anesthetics, sclerosants, botulinum toxins, or other agents. In contrast, dry needling requires the insertion of thin monofilament needles, as used in the practice of acupuncture, without the use of injectate into muscles, ligaments, tendons, subcutaneous fascia, and scar tissue. Dry needles may also be inserted in the vicinity of peripheral nerves and/or neurovascular bundles in order to manage a variety of neuromusculoskeletal pain syndromes. Nevertheless, some position statements by several US State Boards of Physical Therapy have narrowly defined dry needling as an ‘intramuscular’ procedure involving the isolated treatment of ‘myofascial trigger points’ (MTrPs).Objectives:To operationalize an appropriate definition for dry needling based on the existing literature and to further investigate the optimal frequency, duration, and intensity of dry needling for both spinal and extremity neuromusculoskeletal conditions.Major findings:According to recent findings in the literature, the needle tip touches, taps, or pricks tiny nerve endings or neural tissue (i.e. ‘sensitive loci’ or ‘nociceptors’) when it is inserted into a MTrP. To date, there is a paucity of high-quality evidence to underpin the use of direct dry needling into MTrPs for the purpose of short and long-term pain and disability reduction in patients with musculoskeletal pain syndromes. Furthermore, there is a lack of robust evidence validating the clinical diagnostic criteria for trigger point identification or diagnosis. High-quality studies have also demonstrated that manual examination for the identification and localization of a trigger point is neither valid nor reliable between-examiners.Conclusions:Several studies have demonstrated immediate or short-term improvements in pain and/or disability by targeting trigger points (TrPs) using in-and-out techniques such as ‘pistoning’ or ‘sparrow pecking’; however, to date, no high-quality, long-term trials supporting in-and-out needling techniques at exclusively muscular TrPs exist, and the practice should therefore be questioned. The insertion of dry needles into asymptomatic body areas proximal and/or distal to the primary source of pain is supported by the myofascial pain syndrome literature. Physical therapists should not ignore the findings of the Western or biomedical ‘acupuncture’ literature that have used the very same ‘dry needles’ to treat patients with a variety of neuromusculoskeletal conditions in numerous, large scale randomized controlled trials. Although the optimal frequency, duration, and intensity of dry needling has yet to be determined for many neuromusculoskeletal conditions, the vast majority of dry needling randomized controlled trials have manually stimulated the needles and left them in situ for between 10 and 30 minute durations. Position statements and clinical practice guidelines for dry needling should be based on the best available literature, not a single paradigm or school of thought; therefore, ...

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Section: Trp Needling Is Only One Kind Of Dry Needlingmentioning

confidence: 99%

Section: Multiple Needles Should Be Left In Situ For 10–30 Minutesmentioning

confidence: 99%

Dry needling: a literature review with implications for clinical practice guidelines

Dunning¹,

Butts

Mourad³

et al. 2014

Physical Therapy Reviews

241

210

View full text Add to dashboard Cite

show abstract

“…de Abreu Venancio et al 11 compared the treatment effects of botulism injection, lidocaine injection, and DN in 45 patients with headaches who were randomly assigned to 1 of 3 groups. All 3 treatment groups produced significant improvement (P<.05) in pain intensity, duration, and frequency, along with obtainment time and duration of relief.…”

Section: Discussion Gmentioning

confidence: 99%

“…11,33,34,47 The change in nomenclature was due to findings that, in most cases, contractile tissues, not the bursa, are injured, and that inflammation is often not involved. 3,4,11,33,37 Greater trochanteric pain syndrome may include a number of disorders involving the lateral hip, such as bursitis, gluteal tears, external coxa saltans (snapping hip), and trigger points in contractile tissue crossing the hip. 29 Cortisone injection into the lateral hip, with the intention of injecting the bursa, has been a traditionally accepted treatment for this condition.…”

mentioning

confidence: 99%