To examine the short- and long-term effectiveness of dry needling on disability, pain, and patient-perceived improvements in patients with mechanical neck pain when added to a multimodal treatment ...program that includes manual therapy and exercise.
Randomized controlled trial.
Seventy-seven adults (mean ± SD age, 46.68 ± 14.18 years; 79% female) who were referred to physical therapy with acute, subacute, or chronic mechanical neck pain were randomly allocated to receive 7 multimodal treatment sessions over 4 weeks of (1) dry needling, manual therapy, and exercise (needling group); or (2) sham dry needling, manual therapy, and exercise (sham needling group). The primary outcome of disability (Neck Disability Index score) and secondary outcomes of pain (current and 24-hour average) and patient-perceived improvement were assessed at baseline and follow-ups of 4 weeks, 6 months, and 1 year by blinded assessors. Between-group differences were analyzed with a 2-way, repeated-measures analysis of variance. Global rating of change was analyzed with a Mann-Whitney
test.
There were no group-by-time interactions for disability (Neck Disability Index: F
= 0.42,
= .69), current pain (visual analog scale: F
= 1.04,
= .37), or average pain over 24 hours (F
= 0.01,
= .10). There were no between-group differences for global rating of change at any time point (
≥.65). Both groups improved over time for all variables (Neck Disability Index: F
= 124.70,
<.001; current pain: F
= 64.28,
<.001; and average pain over 24 hours: F
= 76.69,
<.001).
There were no differences in outcomes between trigger point dry needling and sham dry needling when added to a multimodal treatment program for neck pain. Dry needling should not be part of a first-line approach to managing neck pain.
.
Background:
During physical activity and exercises, there is more stress and forces are exerted on the tendon, which increases the risk of injury. There are several studies that suggest dry needling ...has a positive effect in treating tendinopathy. Corticosteroid injections are the most commonly used treatment for acute and chronic tendon lesions. In this review, we will compare different lines of treatment; dry needling and corticosteroid injections for tendinopathy and their efficacy in reducing symptoms. The aim of this systematic review is to critically analyze the literature to find the effect of dry needling when compared with corticosteroid injection in treating tendinopathy.
Method:
This systematic review was directed according to “Preferred Reporting Items for Systematic Reviews and Meta-analysis” guidelines. The principal research question that was studied “Is dry needling better than corticosteroid injections in treating tendinopathy?” Various different electronic databases were used to search relevant articles using different keywords. Articles were collected altogether and selected on the basis of eligibility criteria. The closing sets of articles were selected after complete screening.
Result:
Both dry needling and corticosteroid injections are effective in treating tendinopathy for both short term whereas dry needling is more significantly effective in long-term use.
Conclusion:
Dry needling is superior to corticosteroid injection in treating tendinopathy.
Background
Melasma is a difficult to treat pigmentation disorder. However, some successes have been attained by microneedling. The aim of the present study was to evaluate the efficacy of ...microneedling using meso‐depigmentation solution (mesoneedling) in comparison with standard microneedling, over a 4‐month treatment period.
Methods
As a part of this pilot study, 20 patients received microneedling on one side and mesoneedling on another side of their face. Treatment was repeated on a monthly basis for 4 months. Treatment efficacy was defined through Dermacatch® colorimetry, modified Melasma Area and Severity (mMASI) score determination, Investigator's Global Assessment (IGA), and patient questionnaires, whereby all assessments were conducted at the baseline, as well after 2 and 4 months of treatment.
Results
Before treatments, mean difference between pigmented and normal skin calculated by Dermacatch® was 43.7 ± 20.12 and 44.6 ± 20.72 in microneedling sides and mesoneedling sides, respectively. After two and four sessions, these values declined to 34.5 ± 16.26 and 28.05 ± 13.79 on the side subjected to microneedling, while 29.75 ± 15.07 and 20.45 ± 10.58 were measured on the mesoneedling side. Statistically significant differences have been observed between microneedling and mesoneedling treatments at both time points (P = .0001, P = .0001). The mMASI scores obtained upon treatment completion were significantly lower on both the microneedling and the mesoneedling side. The IGA and patients' self‐assessment scores further confirmed that both treatments were effective in treating melasma, without producing any notable side‐effects or complications.
Conclusion
In sum, both microneedling and mesoneedling are effective in decreasing melanin content in the epidermal melasma lesions.
To compare the effects of spinal thrust manipulation and electrical dry needling (TMEDN group) to those of nonthrust peripheral joint/soft tissue mobilization, exercise, and interferential current ...(NTMEX group) on pain and disability in patients with subacromial pain syndrome (SAPS).
Randomized, single-blinded, multicenter parallel-group trial.
Patients with SAPS were randomized into the TMEDN group (n = 73) or the NTMEX group (n = 72). Primary outcomes included the Shoulder Pain and Disability Index and the numeric pain-rating scale. Secondary outcomes included the global rating of change scale (GROC) and medication intake. The treatment period was 6 weeks, with follow-ups at 2 weeks, 4 weeks, and 3 months.
At 3 months, the TMEDN group experienced greater reductions in shoulder pain and disability (
<.001) compared to the NTMEX group. Effect sizes were large in favor of the TMEDN group. At 3 months, a greater proportion of patients within the TMEDN group achieved a successful outcome (GROC score of 5 or greater) and stopped taking medication (
<.001).
Cervicothoracic and upper-rib thrust manipulation combined with electrical dry needling resulted in greater reductions in pain, disability, and medication intake than nonthrust peripheral joint/soft tissue mobilization, exercise, and interferential current in patients with SAPS. The effects were maintained at 3 months.
.
Background: Functional dry needling (FDN) is a technique, most commonly used by physical therapist for the management of musculoskeletal disorders. Hamstrings are one of the most commonly observed ...muscles prone to tightness. Functional dry needling (FDN) is considered a novel technique for the treatment of shortened hamstring. Objective: To explore the effects of functional dry needling (FDN) on the length of shortened hamstring muscle & lower extremity functional scale. Methodology: A quasi-experimental single group, Pretest-Posttest clinical design was conducted at Saidu Group of Teaching Hospital, Swat from September 2020 to March 2021. A total of 32 patients whose ages ranged from 18-40 years, had hamstring lengths less than 70O on goniometer during 90-90 SLR test, Subjects with other conditions such as pulled hamstrings, hyper lordosis, and flat back can lead to hamstring shortening were recruited in this study. The data was measured via goniometer, 90-90 SLR test and LEFs (Lower Extremity Functional Scale) before and immediately after treatment. Functional dry needling FDN was applied at certain points on the Biceps femoris, semitendinosus and semimembranosus. Treatment time was kept at 20 sec for each muscle, total treatment time was 1 minute. Results: The male participants with a mean age of 29.59 ± 5.10 years were recruited. The majority of patients whose hamstring tightness was due to pulled hamstring (37.0%) followed by postural flat back (29.6 %), and lumber hyper lordosis (18.5%). The mean ±SD of hamstring length before and after intervention was 73.37 ± 3.99 & 77.93 ± 4.81. However, the mean ± SD of LEFS scores Pre and Post intervention was 54.44 ± 10.25 & 58.30 ± 11.13 respectively. A significant difference was observed in both Hamstring Length and in LEFS scores between pre- and post-study with a P=0.001 (P<0.05). Conclusion: This study concluded that functional DN may increase the hamstring length and enhances daily functional activities.
Systematic review and meta-analysis.
Myofascial pain syndrome (MPS) is associated with hyperalgesic zones in muscle called myofascial trigger points. When palpated, active myofascial trigger points ...cause local or referred symptoms, including pain. Dry needling involves inserting an acupuncture-like needle into a myofascial trigger point, with the goal of reducing pain and restoring range of motion.
To explore the evidence regarding the effectiveness of dry needling to reduce pain in patients with MPS of the upper quarter.
An electronic literature search was performed using the key word dry needling. Articles identified with the search were screened for the following inclusion criteria: human subjects, randomized controlled trial (RCT), dry needling intervention group, and MPS involving the upper quarter. The RCTs that met these criteria were assessed and scored for internal validity using the MacDermid Quality Checklist. Four separate meta-analyses were performed: (1) dry needling compared to sham or control immediately after treatment, (2) dry needling compared to sham or control at 4 weeks, (3) dry needling compared to other treatments immediately after treatment, and (4) dry needling compared to other treatments at 4 weeks.
The initial search yielded 246 articles. Twelve RCTs were ultimately selected. The methodological quality scores ranged from 23 to 40 points, with a mean of 34 points (scale range, 0-48; best possible score, 48). The findings of 3 studies that compared dry needling to sham or placebo treatment provided evidence that dry needling can immediately decrease pain in patients with upper-quarter MPS, with an overall effect favoring dry needling. The findings of 2 studies that compared dry needling to sham or placebo treatment provided evidence that dry needling can decrease pain after 4 weeks in patients with upper-quarter MPS, although a wide confidence interval for the overall effect limits the impact of the effect. Findings of studies that compared dry needling to other treatments were highly heterogeneous, most likely due to variance in the comparison treatments. There was evidence from 2 studies that lidocaine injection may be more effective in reducing pain than dry needling at 4 weeks.
Based on the best current available evidence (grade A), we recommend dry needling, compared to sham or placebo, for decreasing pain immediately after treatment and at 4 weeks in patients with upper-quarter MPS. Due to the small number of high-quality RCTs published to date, additional well-designed studies are needed to support this recommendation.
Therapy, level 1a-.
To systematically review the evidence about the effectiveness of manual therapy (MT) on pain intensity, frequency and impact of headache in individuals with tension-type headache (TTH).
Medline, ...Embase, Scopus, Web of Science, CENTRAL, and PEDro were searched in June 2020. Randomized controlled trials that applied MT not associated with other interventions for TTH were selected. The level of evidence was synthesized using GRADE, and Standardized Mean Differences (SMD) were calculated for meta-analysis.
Fifteen studies were included with a total sample of 1131 individuals. High velocity and low amplitude techniques were not superior to no treatment on reducing pain intensity (SMD = 0.01, low evidence) and frequency (SMD = −0.27, moderate evidence). Soft tissue interventions were superior to no treatment on reducing pain intensity (SMD = −0.86, low evidence) and frequency of pain (SMD = −1.45, low evidence). Dry needling was superior to no treatment on reducing pain intensity (SMD = −5.16, moderate evidence) and frequency (SMD = −2.14, moderate evidence). Soft tissue interventions were not superior to no treatment and other treatments on the impact of headache.
Manual therapy may have positive effects on pain intensity and frequency, but more studies are necessary to strengthen the evidence of the effects of manual therapy on subjects with tension-type headache.
Implications for rehabilitation
Soft tissue interventions and dry needling can be used to improve pain intensity and frequency in patients with tension type headache.
High velocity and low amplitude thrust manipulations were not effective for improving pain intensity and frequency in patients with tension type headache.
Manual therapy was not effective for improving the impact of headache in patients with tension type headache.
•Dry needling and face yoga effectively reduce pain, bringing relief to TMD patients.•Dry needling and face yoga improve sleep quality in TMD patients.•Dry needling and face yoga improve ...mouth-opening in TMD patients.•Consider dry needling and face yoga before TMD surgery.
Temporomandibular joint dysfunction (TMD) poses significant challenges due to its diverse symptoms and impact on patients' daily lives.
This study aimed to explore the effectiveness of two innovative interventions, dry needling and face yoga, in managing TMD-related issues such as pain, depression, and sleep quality.
Ninety patients with TMD symptoms were enrolled in a prospective randomized controlled trial. The patients were divided into three groups: dry needling, face yoga, and a control group. Various assessments, including Visual Analog Scale for pain, Beck Depression Inventory for depression, and Pittsburgh Sleep Quality Index for sleep quality, were conducted before and 6 weeks after the interventions.
A decrease in pain levels and a statistically significant increase in jaw joint movements (mouth opening, protrusive movement, lateral movements) were observed in the dry needling and face yoga groups after treatment (p <0.05). Additionally, improvements in sleep quality were observed (p <0.05).
Dry needling and face yoga interventions demonstrated efficacy in managing TMD symptoms, including pain relief and improved jaw movement. The findings suggest that these interventions can be valuable additions to the treatment regimen for patients suffering from TMD-related issues. However, further research is warranted to explore the long-term effects and mechanisms underlying these interventions in TMD management.
Deep dry needling is an evidence-based treatment technique that is accepted and used by physical therapists for treatment of musculoskeletal pain. We present a case of iatrogenic pneumothorax due to ...deep dry needling over the posterior thorax. A 36-year old presented with right chest pain 2 hours after dry needling for pain in his back muscles. Chest radiograph suggested small right pneumothorax and the finding was confirmed by computed tomography. Not only should practitioners and their patients be aware of potential complications of dry needling, but also physicians who might see patients with complications.
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