Effectiveness of Different Deep Dry Needling Dosages in the Treatment of Patients With Cervical Myofascial Pain

Abstract

DDN in the upper trapezius MTrP improved pain at a 1-wk follow-up, but improvements were not significantly different among DDN dosages. A higher number of patients with neck pain improvements superior to the moderate clinically important differences were observed when eliciting 6 LTRs and LTRs until exhaustion compared with not eliciting LTRs.

Postneedling Soreness and Tenderness After Different Dosages of Dry Needling of an Active Myofascial Trigger Point in Patients With Neck Pain: A Randomized Controlled Trial

“…Previous research has showed similar results with regard to the proportion of patients with neck pain who perceived postneedling soreness in the upper trapezius [13,[40][41][42]. In the present study, 94.2% of patients presented postneedling soreness, whereas other studies observed proportions of 55% [40,41], 88% [42], or 91.4% [13].…”

“…Multiple insertions are necessary to elicit LTRs until exhaustion, whereas low‐dosage techniques only require few insertions. A recent study investigated the clinical effectiveness of different dosages of DDN and did not show significant differences between groups, but high dosages seem to be associated with greater clinical relevance of pain improvements [13]. However, high DDN dosages may be associated with increased levels of postneedling soreness.…”

“…Mild adverse events after DDN, including bruising, bleeding, or soreness, are considered very common [12]. The presence of postneedling soreness was observed in a high proportion of pain patients after deep DDN techniques of MTrPs in the neck region (91.4%) [13], shoulder (100%) [14], or low back (83%) [15]. The clinical relevance of postneedling soreness remains uncertain, but it has been associated with reduced treatment adherence [16,17] and it is considered capable of influencing patients’ functionality in daily life activities [18].…”

“…To the authors' knowledge, no previous studies have compared postneedling soreness prevalence or intensity between different dosages of DDN in patients with myofascial pain. Previous research has shown that in case DDN reproduces LTRs the clinical relevance of the improvements on pain is increased [13]. However, postneedling soreness prevalence and intensity also may be greater.…”

Advances in the diagnosis and management of neck pain

“…81 Many randomized trials have evaluated trigger point injections, but they generally have methodological flaws such as use as a standalone treatment and the lack of a true placebo group (dry needling could be beneficial). 82 Some evidence suggests that trigger point injections alone are not more effective than less invasive treatments such as laser and ultrasound, and that injections with anything, including saline, are better tolerated and more effective than dry needling. [83][84][85] One randomized trial in 80 people with chronic whiplash disorders found no significant benefit for dry needling with exercise compared with exercise and sham needling.…”