Comparison of acute effects of superficial and deep dry needling into trigger points of suboccipital and upper trapezius muscles in patients with cervicogenic headache

Sedighi, Asefeh; Ansari, Noureddin Nakhostin; Naghdi, Soofia

doi:10.1016/j.jbmt.2017.01.002

Cited by 45 publications

(40 citation statements)

References 35 publications

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“…After this review, some clinical trials have been published. Sedighi et al compared superficial (skin-biased) versus deep (muscle-biased) dry needing over the suboccipital and upper trapezius musculature in people with CeH and showed that both needling approaches were similarly effective for reducing headaches, but deep dry needling was more effective for improving function [55]. A recent randomized clinical trial found that real dry needling over active TrPs located in the neck and head musculature was more effective than sham needling for reducing headache pain parameters, e.g., intensity, frequency, and duration of headache, and for improving health-related quality of life in patients with chronic TTH [56].…”

Section: Scientific Evidence Of Needling Therapies Interventions For mentioning

confidence: 99%

Clinical Reasoning Behind Non-Pharmacological Interventions for the Management of Headaches: A Narrative Literature Review

Fernández‐de‐las‐Peñas

Plaza-Manzano

Arias-Buría

2020

IJERPH

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Headache is the clinical syndrome most commonly observed by neurologists in daily practice. Pharmacological and non-pharmacological treatments are commonly used for the management of headaches; however, the clinical reasoning behind these interventions is not properly applied. We conducted a narrative literature review using as data sources for academic PubMed, MEDLINE, EMBASE, AMED, CINAHL, EBSCO, PEDro, Cochrane Database of Systematic Reviews, Cochrane Collaboration Trials Register, and SCOPUS. This narrative literature review mainly considered systematic reviews, meta-analyses, randomised clinical trials, and expert opinions published after the year 2000 discussing clinical reasoning for application of non-pharmacological interventions in individuals with tension-type, migraine, and cervicogenic headaches. After the data extraction, we organized the literature thematically as follows: (1) mapping of theoretical aspects of non-pharmacological interventions; (2) summarizing most updated literature about effectiveness of non-pharmacological interventions grouped by targeted tissue and headache; (3) identifying research gaps in the existing literature and proposing hypotheses for better understanding of current clinical reasoning. We found that there are many non-pharmacological treatment strategies used for headaches, including beyond the tissue-based impairment treatments (bottom-up) and strategies targeting the central nervous system (top down). Bottom-up strategies include joint-biased, soft-tissue biased, or needling interventions, whereas top-down strategies include exercise and cognitive interventions. Evidence shows that the effectiveness of these interventions depends on the application of proper clinical reasoning, since not all strategies are effective for all headaches. For instance, evidence of non-pharmacological interventions is more controversial for migraines than for tension-type or cervicogenic headaches, since migraine pathogenesis involves activation of sub-cortical structures and the trigemino- vascular system, whereas pathogenesis of tension-type or cervicogenic headaches is most associated to musculoskeletal impairments of the cervical spine. We conclude that current literature suggests that not all non-pharmacological interventions are effective for all headaches, and that multimodal, not isolated, approaches seem to be more effective for patients with headaches. Most published studies have reported small clinical effects in the short term. This narrative literature review provides some hypotheses for discrepancies in the available literature and future research. Clinical reasoning should be applied to better understand the effects of non-pharmacological interventions.

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Section: Scientific Evidence Of Needling Therapies Interventions For mentioning

confidence: 99%

Clinical Reasoning Behind Non-Pharmacological Interventions for the Management of Headaches: A Narrative Literature Review

Fernández‐de‐las‐Peñas

Plaza-Manzano

Arias-Buría

2020

IJERPH

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“…It can be classified as deep or superficial [9]. There is not much evidence about which of the two options is better, it seems that deep dry needling has shown greater effectiveness due to penetrating the myofascial trigger point while the superficial dry needling penetrates the skin and the subcutaneous cellular tissue [10,11]. In the same way, the appearance of local twitch response would guarantee its effectiveness [12,13].…”

Section: Introductionmentioning

confidence: 99%

Needling Therapies in the Outpatient Care: Adverse Effects

Llamas-Ramos¹,

Llamas-Ramos²

2022

Ultimate Guide to Outpatient Care

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The invasive techniques have been used for many years. There is a lot of literature on the advances that have been made, as well as the adverse effects or possible complications that have occurred during the performance of these treatments. Acupuncture and injections (saline, anesthetics, corticosteroids or botulinum toxin) have reported several cases of complications. Dry needling is also beginning to have several publications of this type. The objective of this chapter is to summarize the articles published in relation to adverse effects of needling therapies to promote a good practice and knowledge. Original articles in form of randomized controlled trials, case reports and reviews relating adverse effects and possible complications due to invasive/needling techniques: acupuncture, injections and dry needling have been included. 102 articles met the inclusion criteria between January 2000 and January 2020. The first limitation found in the literature was the huge variety of cases, therapists and incidents to generalize. As a conclusion we can stated the importance of a good knowledge of the anatomy and its variants, the correct application of these techniques and a continuous training of these therapists must be essential.

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“…The majority of dry needling studies involve deep needling into MTrP for pain relief [13]. Deep needle penetration has not consistently demonstrated superior results compared to superficial needle insertion [14][15][16]. Acupuncture can also be applied using deep or superficial needle insertion for pain management related to painful orthopedic conditions [17].…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of superficial versus deep dry needling or acupuncture for reducing pain and disability in individuals with spine-related painful conditions: a systematic review with meta-analysis

Griswold

Wilhelm

Donaldson

et al. 2019

Journal of Manual & Manipulative Therapy

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Objective: The purpose of this systematic review was to evaluate the effects of deep versus superficial dry needling or acupuncture on pain and disability for spine-related painful conditions. A secondary purpose was to account for the differences of needling location in relation to the painful area. Methods: This PROSPERO (#CRD42018106237) registered review found 691 titles through a multi-database search. Following a comprehensive search, 12 manuscripts were included in the systematic review and 10 in the meta-analysis. Standardized mean differences (SMD) with 95% confidence intervals were calculated for pain and disability.Results: The included studies demonstrated an unclear to high risk of bias recommending a cautious interpretation of the results. A consistent effect supporting deep needling over superficial with an SMD of 0.585 [0.335, 0.835], p < 0.001 from 10 articles for pain but a nonsignificant effect of 0.197 [−0.066, 0.461], p = 0.14 from 2 studies for disability. A temporal examination was similar for effects on pain with an SMD of 0.450 [0.104, 0.796] immediately, 0.711 [0.375, 1.048] short-term (1 to 11 weeks), and 0.470 [0.135, 0.805] for time-points ≥12 weeks. Regionally, there was a greater effect needling the area of pain locally (SMD = 0.754) compared to remotely (SMD = 0.501). Discussion: Statistically significant between-group differences were observed favoring deep needling over superficial. Both superficial and deep needling resulted in clinically meaningful changes in pain scores over time. However, differences between groups may not be clinically meaningful. More high-quality trials are needed to better estimate the effect size of deep versus superficial needling while controlling for location and depth of the lesion.

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Comparison of acute effects of superficial and deep dry needling into trigger points of suboccipital and upper trapezius muscles in patients with cervicogenic headache

Cited by 45 publications

References 35 publications

Clinical Reasoning Behind Non-Pharmacological Interventions for the Management of Headaches: A Narrative Literature Review

Clinical Reasoning Behind Non-Pharmacological Interventions for the Management of Headaches: A Narrative Literature Review

Needling Therapies in the Outpatient Care: Adverse Effects

The effectiveness of superficial versus deep dry needling or acupuncture for reducing pain and disability in individuals with spine-related painful conditions: a systematic review with meta-analysis

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