Efficacy of Dry Needling Under EMG Guidance for Myofascial Neck and Shoulder Pain: A Randomized Clinical Trial

Abstract

To determine the difference in maintenance of improvement of pain and disability for dry needling (DN) under needle electromyography (EMG) guidance technique in myofascial neck and shoulder pain patients, compared with DN alone. Patients and Methods: In this randomized single-blind clinical trial, 30 participants with myofascial pain in the neck and shoulder were randomly allocated to two groups: myofascial trigger points (MTrPs) DN with EMG guided (DN-EMG) group and MTrPs DN without EMG (DN) group. Needling treatment lasted for 2 weeks, twice a week. The primary outcome was pain intensity as assessed by visual analogue scale (VAS) and neck disability index (NDI). A number of mappings referred to pain and spontaneous muscle activity (SEA) were considered secondary outcomes. VAS and NDI were measured before treatment, after 2 weeks of intervention and at 4-, 6-and 12-week follow-up periods after the intervention. Secondary outcomes were assessed before each treatment (T1-T4). Data were analysed using mixed-model analyses of variance (ANOVA) with time as a within-subject variable and groups as betweensubject variables followed by Bonferroni's post-hoc test.Results: Mixed-model ANOVA revealed significant time-by-group interaction effects (F = 3.49, P = 0.01) for VAS. Post-hoc analysis showed a significant decrease in VAS and NDI after 2 weeks of intervention and at all follow-up periods compared with baseline in both groups (p < 0.01). The DN-EMG group exhibited higher improvements in VAS at 6-and 12-week follow-up period than the DN group (p < 0.05). In the SEA of MTrPs, we found positive sharp waves, fibrillation and fascicular potentials. DN-EMG group exhibited lower amplitudes at T2-T4 and frequencies at T2 and T3. Conclusion: DN under needle EMG guidance technique exhibited greater improvements in maintenance of improvement of pain and lower SEA value than the DN group due to sufficient MTrPs inactivation.

Using Dry Needling to Improve the Quality of Life of Patients With Shoulder Dysfunction Following Neck Dissection: An Innovative Case Report

“…MTrPs are defined as hyperirritable spots in a palpable taut band of skeletal muscle fibers, giving rise to characteristic referred pain, motor dysfunction, and autonomic phenomena [9,10]. Trauma, overuse of the muscle, postural habits, emotional and psychological stresses, and endocrine, metabolic, and nutritional deficiencies can precipitate MTrPs [11].…”

Intramuscular Electrical Stimulation to Trigger Points: Insights into Mechanisms and Clinical Applications—A Scoping Review

“…In a recent study, dry needling to trigger spots (TrSs) in rats was shown to decrease the EPN at the TrS site, with corresponding decreases in the concentrations of ACh, and increases in acetylcholinesterase [ 58 ]. A recent study on human subjects revealed that dry needling under needle EMG guidance significantly reduced pain along with the amplitude and frequency of EPN at the TrP, compared to a control group that had dry needling performed without needle EMG guidance [ 59 ]. Both studies suggest that precise needling within the TrP results in greater TrP inactivation due to a reduction in ACh levels, and therefore pain relief.…”

Komplementärmedizin in der Therapie von Schulterschmerzen – eine Übersicht über relevante Studien und Metaanalysen

“…Bestimmte mTrP-Massagetechniken können jedoch ebenso effektiv sein wie das DN selbst 65 . Eine aktuelle Arbeit liefert außerdem Hinweise, dass durch Ultraschall gestütztes DN die Aktivität von mTrP stärker verringert und somit Schmerz und Funktion mittelfristig (hier drei Monate) mehr verbessert werden als durch klassisches DN 66 . Bei Profi-Handballspielern konnten Schulterschmerzen, Kraft- und Bewegungseinschränkungen während der Wurfbewegung mit einer einzigen ultraschallgestützten DN-Behandlung am M. teres major nahezu aufgelöst werden 67 .…”