Dry Needling to a Key Myofascial Trigger Point May Reduce the Irritability of Satellite MTrPs

Hsieh, Yueh Ling; Kao, Mu Jung; Kuan, Ta Shen; Chen, Shu Min; Chen, Jo Tong; Hong, Chang Zern

doi:10.1097/phm.0b013e31804a554d

Cited by 202 publications

(165 citation statements)

References 40 publications

(48 reference statements)

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“…[8] On the other hand Hsieh et al used 25 G hypodermic needles for dry needling (peppering technique) in 14 MPS patients, and peppering was found effective for reducing pain and improving range of motion immediateley after the procedure. [17] Hong et al also used the peppering technique but assessed only the immediate effects in their study too. [12] In another study demonstrating peppering technique is as effective as lidocain injection, 80 patients were evaluated on 4 th and 12 th week after the procedures, but the effect of the treatments within the first month is unknown.…”

Section: Discussionmentioning

confidence: 99%

Comparision of two different dry-needling techniques in the treatment of myofascial pain syndrome

Bölük¹

2016

Agri

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SummaryObjectives: To compare the efficacy of two different dry needling (DN) techniques (deep dry needling & peppering) in myofascial pain syndrome (MPS). Methods: Seventy-two patients, who were diagnosed as MPS at our outpatient clinic were randomly assigned into two groups as deep dry needling (DDN) and peppering. All patients were evaluated four times as: before the treatment and 1-5-12 weeks after the completion of treatment protocol. In each evaluation, Visual analogue scale (VAS), Nottingham extended activities of daily living scale (NEADLS), Beck depression inventory (BDI) scores were recorded. Additionally, all patients were evaluated for the pain felt during the procedure and side effect profile. Results: Twenty-six patients from DDN group and twenty-eight patients from peppering group accomplished the follow-up period. Both DDN and peppering seem to be effective for relieving pain and depressive symptoms and improving functionality compared to baseline when evaluated on the 1 st , 5 th and 12 th weeks. On the other hand the intergroup analyses showed no significant differences between DDN and peppering groups. The only significant difference between the groups is the lesser pain felt during the procedure in the DDN group. Conclusion: Both DDN and peppering are effective in MPS and the effects last up to 12 weeks. Also the adverse event profiles of the two techniques are similar. On the other hand, DDN is a painless procedure.Keywords: Deep dry needling; dry needling; myofascial pain syndrome; peppering. ÖzetAmaç: Çalışmanın amacı iki farklı kuru iğneleme yönteminin (derin kuru iğneleme ve peppering) miyofasial ağrı sendromunda (MAS) karşılaştırılması. Gereç ve Yöntem: Hastanemize başvuran MAS tanısı alan 72 hasta, rasgele derin kuru iğneleme ve peppering olmak üzere iki gruba ayrıldı. Tüm hastalar 4 kez değerlendirildi; tedaviden önce ve tedavide uygulamasından sonraki 1.-5. ve 12. haftalarda. Her değerlendirmede hastalara Vizüel Analog Skala, Nottingham Genişletilmiş Günlük Yaşam Aktiviteleri Skalası ve Beck Depresyon Ölçeği uygulandı. Ek olarak hastalar prosedür boyunca ağrı hissi ve yan etki profili açısından takip edildi. Bulgular: Takip sürecini 26 derin kuru iğneleme ve 28 peppering hastası tamamladı. Başlangıca göre bakıldığında her iki grupta da 1.-5. ve 12. hafta kontrollerinde ağrının azaltılması, depresif semptomları ve fonksiyonelliğin artırlması açısından fayda sağlandı. Öte yandan gruplararası analizlerde her iki grup arasında anlamlı fark saptanmadı. Her iki grup arasındaki tek anlamlı farklılık uygulama sırasında derin kuru iğneleme grubunda ağrının daha az olmasıydı. Sonuç: Derin kuru iğneleme de peppering de MAS tedavisinde etkili ve bu etki 12 haftaya kadar devam etmektedir. Ayrıca her iki tekniğin de yan etki profili benzer saptandı. Öte taraftan, derin kuru iğnelemenin daha ağrısız bir prosedür olduğu görüldü.Anahtar sözcükler: Derin kuru iğneleme; kuru iğneleme; myofasial ağrı sendromu; peppering.

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Section: Discussionmentioning

confidence: 99%

Comparision of two different dry-needling techniques in the treatment of myofascial pain syndrome

Bölük¹

2016

Agri

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“…19 Patients were also excluded if they had a history of fibromyalgia syndrome, whiplash injury, cervical spine surgery and fracture, cervical radiculopathy, having MTP therapy within the past month before the study, or if they had a diagnosis of any systematic disease such as rheumatism, tuberculosis, cervical myelopathy, or multiple sclerosis. [25][26][27][28][29] The patients, who underwent DN, also had no contraindication for needling such as local infection, pregnancy with threatened abortion, taking anticoagulants (eg, warfarin), or long-term steroid use. After the initial screening, 31 patients fulfilled all inclusion criteria.…”

Section: Participantsmentioning

confidence: 99%

“…The average value of the 3 repetitive measurements with an interval of 30 to 60 seconds (expressed as kilograms per square centimeter) was taken for data analysis of the PPT. 19,26 …”

Section: Assessment Of Pain Intensitymentioning

confidence: 99%

Clinical Effectiveness of Dry Needling Immediately After Application on Myofascial Trigger Point in Upper Trapezius Muscle

Ziaeifar

Arab

Nourbakhsh

2016

Journal of Chiropractic Medicine

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Objective: The purpose of this study was to investigate the effect of dry needling (DN) on pain intensity and pressure pain threshold (PPT) compared with ischemic compression (IC) immediately and 48 hours after each treatment session in individuals with myofascial trigger points in the upper trapezius muscle. Methods: Thirty-one patients with myofascial trigger points in the upper trapezius muscle participated in this study. Patients were randomly assigned to a standard (N = 17) or experimental group (N = 14). The treatment protocol for the standard group consisted of IC, whereas the patients in the experimental group received DN. Results: The results indicated that the effect size of the DN methods for pain intensity and PPT was considerably greater after 2 days compared with immediately after the treatment session. In contrast, the effect of the IC for PPT was greater immediately after treatment compared with the measures after 2 days. There was also no noticeable difference in the effect size for IC on pain intensity between the scores obtained immediately and 2 days after treatment. However, our data also revealed a greater effect size for DN on PPT after 2 days compared with the IC technique. Conclusions: In this study, DN improved the pain intensity and PPT after 2 days. However, it had no clinical improvement immediately after application because of muscle soreness. Thus, assessment of the effect of DN immediately after application can be criticized, and the results should be interpreted with caution. (J Chiropr Med 2016;15:252-258)

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“…[19][20][21][22] Two clinical trials have reported that DDN of MTrP improves joint ROM and pressure pain threshold (PPT) of MTrP in treated muscles and attains the same effects in MTrPs located in the referred pain area. 23,24 Furthermore, DDN of MTrP improves PPT, ROM and reduces the intensity of pain from MTrP in proximal muscles. 24 Although both studies show positive results, the lack of proper controls, the small sample size and the lack of follow-up in the short and medium term and methodological issues regarding blinding mean that it is not possible unequivocally to establish the effectiveness of DDN in the treatment of MTrPs.…”

Section: 6-8mentioning

confidence: 99%

“…24 Although both studies show positive results, the lack of proper controls, the small sample size and the lack of follow-up in the short and medium term and methodological issues regarding blinding mean that it is not possible unequivocally to establish the effectiveness of DDN in the treatment of MTrPs. 23,24 A recent study with an interesting placebo methodology, proper blinding but a small sample size shows promising results for DDN in MTrP pain after total knee replacement surgery and warrants the need for more high quality research in MPS.…”

Section: 6-8mentioning

confidence: 99%

Dry needling of the trapezius muscle in office workers with neck pain: a randomized clinical trial

Cerezo-Téllez¹,

Torres-Lacomba²,

Fuentes-Gallardo³

et al. 2016

Journal of Manual & Manipulative Therapy

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Background: Neck pain is a frequent complaint in office workers. This pain can be caused by myofascial trigger points (MTrPs) in the trapezius muscle. This study aimed to determine the effectiveness of deep dry needling (DDN) of active MTrPs in the trapezius muscle. Methods: A randomized, single blinded clinical trial was carried out at the Physical Therapy Department at Physiotherapy in Women's Health Research Group at Physical Therapy Department of University of Alcalá, in Alcalá de Henares, Madrid, Spain. Forty-four office workers with neck pain and active MTrPs in the trapezius muscle were randomly allocated to either the DDN or the control group (CG). The participants in the DDN group were treated with DDN of all MTrPs found in the trapezius muscle. They also received passive stretch of the trapezius muscle. The CG received the same passive stretch of the trapezius muscle only. The primary outcome measure was subjective pain intensity, measured using a visual analogue scale (VAS). Secondary outcomes were pressure pain threshold (PPT), cervical range of motion (CROM) and muscle strength. Data were collected at baseline, after interventions and 15 days after the last treatment. Results: Differences were found between the DDN group and the CG for the VAS (P < 0.001), PPT (P < 0.001), range of motion (AROM) (P < 0.05) and strength (P < 0.05) after intervention and at the 15-day follow-up. Discussion: Deep dry needling and passive stretch seems to be more effective than passive stretch only. The effects are maintained in the short term. The results support the use of DDN in the management of trapezius muscle myofascial pain syndrome in neck pain.

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Dry Needling to a Key Myofascial Trigger Point May Reduce the Irritability of Satellite MTrPs

Cited by 202 publications

References 40 publications

Comparision of two different dry-needling techniques in the treatment of myofascial pain syndrome

Comparision of two different dry-needling techniques in the treatment of myofascial pain syndrome

Clinical Effectiveness of Dry Needling Immediately After Application on Myofascial Trigger Point in Upper Trapezius Muscle

Dry needling of the trapezius muscle in office workers with neck pain: a randomized clinical trial

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