Superficial Dry Needling and Active Stretching in the Treatment of Myofascial Pain – a Randomised Controlled Trial

Abstract

A pragmatic, single blind, randomised, controlled trial was conducted to test the hypothesis that superficial dry needling (SDN) together with active stretching is more effective than stretching alone, or no treatment, in deactivating trigger points (TrPs) and reducing myofascial pain. Forty patients with musculoskeletal pain, referred by GPs for physiotherapy, fulfilled inclusion / exclusion criteria for active TrPs. Subjects were randomised into three groups: group 1 (n=14) received superficial dry needling (SDN) and active stretching exercises (G1); group 2 (n=13) received stretching exercises alone (G2); and group 3 (n=13) were no treatment controls (G3). During the three-week intervention period for G1 and G2, the number of treatments varied according to the severity of the condition and subject/clinician availability. Assessment was carried out pre-intervention (M1), post-intervention (M2), and at a three-week follow up (M3). Outcome measures were the Short Form McGill Pain Questionnaire (SFMPQ) and Pressure Pain Threshold (PPT) of the primary TrP, using a Fischer algometer. Ninety-one per cent of assessments were blind to grouping. At M2 there were no significant inter-group differences, but at M3, G1 demonstrated significantly improved SFMPQ versus G3 (p=0.043) and significantly improved PPT versus G2 (p=0.011). There were no differences between G2 and G3. The mean PPT and SFMPQ scores correlated significantly in G1 only, though no significant inter-group differences were demonstrated. Numbers of patients requiring further treatment following the trial were: 6 (G1); 12 (G2); 9 (G3). Conclusion: SDN followed by active stretching is more effective than stretching alone in deactivating TrPs (reducing their sensitivity to pressure), and more effective than no treatment in reducing subjective pain. Stretching without prior deactivation may increase TrP sensitivity.

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

“…[16][17][18][19][20][21] It has been suggested that DN may influence the microcirculation. Several investigators have reported that needle insertion in the muscles increased both skin and muscle blood flow in the stimulated region.…”

“…14,15 Although some previous studies have assessed the effect of DN on MTP in UT muscles, a review of the published reports determined that some randomized clinical trials have been conducted to determine the effectiveness of DN in the treatment of MTP in UT muscle. [16][17][18][19][20][21] However, with the use of different designs, samples, and testing procedures, controversial results have been reported regarding the effect of DN on MTP in UT muscles. [16][17][18][19][20][21] Most of the previous studies have assessed the clinical effectiveness of DN immediately after treatment procedures.…”

“…[16][17][18][19][20][21] However, with the use of different designs, samples, and testing procedures, controversial results have been reported regarding the effect of DN on MTP in UT muscles. [16][17][18][19][20][21] Most of the previous studies have assessed the clinical effectiveness of DN immediately after treatment procedures. 17,[19][20][21] Muscle soreness is a common report after DN application.…”

“…[16][17][18][19][20][21] Most of the previous studies have assessed the clinical effectiveness of DN immediately after treatment procedures. 17,[19][20][21] Muscle soreness is a common report after DN application. 20 Typically, after DN technique the muscle soreness lasts and may be felt for a few hours up to 24 to 48 hours.…”

“…14,[17][18][19][20][21][22] The purpose of this study was to investigate the effect of DN compared with IC on pain intensity and PPT immediately after each treatment session compared with the measurements obtained 48 hours after each treatment session in individuals with MTP in the UT muscle.…”