Ultrasound‐guided dry needling decreases pain in patients with piriformis syndrome

Abstract

Introduction Piriformis muscle syndrome (PMS) is a disorder that can lead to symptoms of buttock pain and limited hip‐joint mobility, and may have an impact on quality of life. Methods Thirty‐two patients with PMS were randomized to the treatment group, which included three sessions of ultrasound‐guided dry needling (DN) of the piriformis muscle (n = 16), or a waitlist control group (n = 16). The primary outcome was pain intensity measured on the visual analog scale recorded at baseline and then at 72 hours and 1 week after treatment. Results At 1‐week follow‐up, pain intensity was significantly less in the DN group than in the waitlist control group (−2.16 [−1.01 to −3.32], P = .007) by an amount consistent with clinically meaningful improvement. Discussion The findings suggest that DN resulted in clinically meaningful short‐term improvement in pain intensity of patients with PMS.

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

“…Latent MTrPs do not produce spontaneous pain unless they are encouraged [6,7]. DN has been shown to increase the pressure pain threshold (PPT) [8] and range of movement (ROM) [9]; to improve function [10]; and to decrease pain in patients with patellofemoral pain syndrome [10], hip osteoarthritis [11], low-back pain [12], and piriformis syndrome [13].…”

The Effects of Ultrasound-guided Dry Needling on Patients With Myofascial Pain Syndrome

“…The results of the study by Tabatabaei et al signified that the group receiving US-guided DN presented significantly better outcomes than the controls in terms of pain relief and internal ROM with a great effect size. However, there was no significant difference between the study groups regarding the increased pressure pain tolerance (with a moderate effect size) and disability (with a small effect size) [22]. The details of the reviewed articles on using US-guided DN, including the author's name, sample size, article type, the number of interventions, study duration, studied variables, and relevant results are listed in Table 1.…”

“…The inclusion criteria of the present review were as follows: retrospective and prospective, experimental, quasiexperimental, and observational studies; English articles on the effects of US-guided DN on MPS, and relevant articles published from 2010 to March 2020. Based on the inclusion and exclusion criteria (using US-guided DN as the main inclusion criterion), a total of 11 articles were finally reviewed [14][15][16][17][18][19][20][21][22][23][24]. Three of these studies were randomized clinical trials, comparing US-guided DN with other treatment methods [15,18,22]; 5 were case reports and case-series [14,17,19,21,24]; two were retrospective analyses of the effect of US-guided DN on the treatment of MPS [16,23], and one was a single-group, pretest, post-test study [20].…”

Ultrasound‐guided trigger point injection for piriformis syndrome in the emergency department

“…8,9 Ultrasound guidance increases the success rate of injection directly into the muscle compared with performing a blind injection or using fluoroscopy. 10 This technique has been used by physiatrists and pain physicians with good results. 11,12 Both of our patients had a significant reduction of pain after receiving the ultrasound-guided TPI, and this persisted at 48 hours after being discharged from the ED.…”

“…Although corticosteroids have been used in the past, recent studies show that they have no added benefit compared with using local anesthetic alone or even dry needling 8,9 . Ultrasound guidance increases the success rate of injection directly into the muscle compared with performing a blind injection or using fluoroscopy 10 . This technique has been used by physiatrists and pain physicians with good results 11,12 .…”