Dry Needling in the Management of Musculoskeletal Pain

Abstract

Myofascial pain is a common syndrome seen by family practitioners worldwide. It can affect up to 10% of the adult population and can account for acute and chronic pain complaints. In this clinical narrative review we have attempted to introduce dry needling, a relatively new method for the management of musculoskeletal pain, to the general medical community. Different methods of dry needling, its effectiveness, and physiologic and adverse effects are discussed. Dry needling is a treatment modality that is minimally invasive, cheap, easy to learn with appropriate training, and carries a low risk. Its effectiveness has been confirmed in numerous studies and 2 comprehensive systematic reviews. The deep method of dry needling has been shown to be more effective than the superficial one for the treatment of pain associated with myofascial trigger points. However, over areas with potential risk of significant adverse events, such as lungs and large blood vessels, we suggest using the superficial technique, which has also been shown to be effective, albeit to a lesser extent.Additional studies are needed to evaluate the effectiveness of dry needling. There also is a great need for further investigation into the development of pain at myofascial trigger points. (J Am Board Fam Med 2010;23:640 -646.)

Spinal and Peripheral Dry Needling Versus Peripheral Dry Needling Alone Among Individuals With a History of Lateral Ankle Sprain: A Randomized Controlled Trial

“…8,[11][12][13]15,16,19,20 Individuals with and without low back pain have demonstrated varied responses in muscle activation following a dry needling intervention to the lumbar multifidi muscles. [21][22][23] Studies investigating the physiological effects of dry needling of the lumbar multifidi muscles in individuals with 22,23 and without low back pain 21 demonstrate changes in nociceptive sensitivity, segmental mobility and motor function following the interventions.…”

“…13,18 Hypersensitivity then develops in skeletal muscles innervated with the nerve root, leading to the development of MTrPs. 15,17,18 Treatment approaches utilizing Gunns' IMS theory 19 suggest that performing dry needling to the muscles of the spine normalizes the resting length of paraspinal muscles, reduces spinal nerve compression and muscle dysfunction along the corresponding myotomes to produce long-lasting pain reduction.…”

A Rare Complication Caused by Dry Needling Method: Tension Pneumothorax

“…(1) Several adverse effects associated specifically with dry needling have been reported. These include soreness after needling, local hemorrhage at the needling site, asyncopal responses, and pneumothorax (1)(2)(3)(4)(5). Pneumothorax is a well-recognized but rare adverse event related to acupuncture or deep dry needling over the thorax.…”

Dry needling on tendons and myofascial trigger points in post-traumatic stiffness of elbow: a case report

“…8 Dry needling in the myofascial trigger points is considered to be a one of the effective intervention in reducing pain and inflammation, 9 improving subcutaneous fibroblast activity, 10 Myofascial flexibility, and increase joint range of motion. 11 This novel technique is effectively used for trigger points deactivation and normalize the sensory motor control in the different level of nervous system. 12 Addition to the dry needling over the myofascial trigger points, tendon needling over muscle origin and insertion may produce widespread muscle relaxation and movement control in post immobilization stiffness of elbow joint.…”