The effectiveness of superficial versus deep dry needling or acupuncture for reducing pain and disability in individuals with spine-related painful conditions: a systematic review with meta-analysis

Abstract

Objective: The purpose of this systematic review was to evaluate the effects of deep versus superficial dry needling or acupuncture on pain and disability for spine-related painful conditions. A secondary purpose was to account for the differences of needling location in relation to the painful area. Methods: This PROSPERO (#CRD42018106237) registered review found 691 titles through a multi-database search. Following a comprehensive search, 12 manuscripts were included in the systematic review and 10 in the meta-analysis. Standardized mean differences (SMD) with 95% confidence intervals were calculated for pain and disability.Results: The included studies demonstrated an unclear to high risk of bias recommending a cautious interpretation of the results. A consistent effect supporting deep needling over superficial with an SMD of 0.585 [0.335, 0.835], p < 0.001 from 10 articles for pain but a nonsignificant effect of 0.197 [−0.066, 0.461], p = 0.14 from 2 studies for disability. A temporal examination was similar for effects on pain with an SMD of 0.450 [0.104, 0.796] immediately, 0.711 [0.375, 1.048] short-term (1 to 11 weeks), and 0.470 [0.135, 0.805] for time-points ≥12 weeks. Regionally, there was a greater effect needling the area of pain locally (SMD = 0.754) compared to remotely (SMD = 0.501). Discussion: Statistically significant between-group differences were observed favoring deep needling over superficial. Both superficial and deep needling resulted in clinically meaningful changes in pain scores over time. However, differences between groups may not be clinically meaningful. More high-quality trials are needed to better estimate the effect size of deep versus superficial needling while controlling for location and depth of the lesion.

Short-term effectiveness of high- and low-intensity percutaneous electrolysis in patients with patellofemoral pain syndrome: A pilot study

“…Although several invasive procedures have been compared ( e.g. , DN with MTrP infiltration (with no significant differences between the methods)[ 31 ], and superficial vs deep DN)[ 32 ], the available evidence comparing DN with percutaneous electrolysis applied to MTrPs is limited. To our knowledge, only one clinical trial has compared percutaneous electrolysis and DN in patients with temporomandibular disorders[ 17 ].…”

Short-Term Effects of PENS versus Dry Needling in Subjects with Unilateral Mechanical Neck Pain and Active Myofascial Trigger Points in Levator Scapulae Muscle: A Randomized Controlled Trial

“…Dry needling (DN) is a therapeutic intervention in which thin needles are used to penetrate the skin to affect the underlying connective tissue and neuromuscular system without the use of any medication [1]. DN techniques can be sorted according to the depth that the needle is inserted [2]. Although in recent years it has been associated with other musculoskeletal problems, most commonly, DN is designed for the treatment of myofascial trigger points (MTrPs) [3,4].…”

Agulhamento seco para alívio da dor em paciente do sexo feminino com hipertrofia bilateral dos músculos masseter e temporal – Relato de caso

“…A técnica do agulhamento seco é um procedimento definido como a penetração de uma agulha sólida, realizada sem a introdução de qualquer droga, e tem seu princípio no rompimento mecânico dos pontos-gatilhos miofaciais (PGM) que estão localizados nos músculos esqueléticos, ocasionando a dor. Após a penetração da agulha, ela é estimulada com intuito de se desfazer o nódulo, resultando em um reflexo espinhal involuntário que é a resposta de contração local de fibras musculares afetadas (Griswold et al, 2019).…”