Dry Needling on Latent and Active Myofascial Trigger Points Versus Oral Diclofenac in Patients With Knee Osteoarthritis: a Randomized Controlled Trial

Abstract

Background: Latent and active myofascial trigger points (MTrPs) in knee-associated muscles may play a key role in pain management among patients with knee osteoarthritis (KOA). The aim of this study was to investigate the effect of dry needling treatment on pain intensity, disability, and range of motion (ROM) in patients with KOA. Methods: This randomized, single-blinded, clinical trial was carried out for 6 weeks of treatment and 6-monthfollow-up. A total of 98 patients met the entry criteria and were randomly assigned to the dry needling latent and active myofascial trigger point (MTrPs) with the stretching group or the oral diclofenacwith the stretching group. Numeric Pain Rating Scale (NPRS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and ROM were statistically analyzed before and after treatment and at the 6-month follow-up. Results: A total of 42 patients in the dry needling group (DNG)and 35 patients in the diclofenac group (DG), respectively,completed the study, and there was no significant difference in the general data between the two groups. After treatments, both the groups showed a good effect in knee pain, function, and ROM, However, the DNG showed asignificantly better result than the DG. Especially in the results of the 6-month follow-up, the DNG showed much better results than the DG. Conclusions: Dry needling on latent and active MTrPscombined with stretching and oral diclofenac combined with stretching can effectively relieve pain, improve function, and restore knee ROM affected by KOA. However, the effects of dry needling and stretching are better and longer lasting than those of oral diclofenac and stretchingfor at least 6 months. Trial registration: Registered in the Chinese Clinical Trial Registry (www.chictr.org.cn) in 17/11/2017 with the following code: ChiCTR-INR-17013432.