: This prospective randomized, controlled pilot trial to explore the immediate effect of adding Mirror Visual Feedback Therapy on pain sensitivity and motor performance among subjects suffering from ...post-needling pain diagnosed as Lateral Elbow Pain.
: A total of 49 participants (23 female, 26 male) were enrolled and randomly allocated to either the experimental group, which received Deep Dry Needling in the m.
, Ischemic Compression, Cold Spray, Stretching, and Mirror Visual Feedback Therapy (
= 25), or a control group without Mirror Visual Feedback Therapy (
= 24). Pre- and post-treatment evaluations included assessments of post-needling pain intensity, pressure pain threshold, two-point discrimination threshold, and maximum hand grip strength.
: Intergroup analysis revealed a statistically significant reduction in post-needling pain intensity favoring the experimental group (U = 188.00,
= 0.034). Additionally, intragroup analysis showed significant improvements in post-needling pain intensity (MD = 0.400, SEM = 0.271, W = 137.00,
= 0.047) and pressure pain threshold (MD = 0.148 Kg/cm
, SEM = 0.038, W = 262.00,
< 0.001) within the experimental group following the intervention.
: These findings suggest a potential benefit of integrating Mirror Visual Feedback Therapy into treatment protocols for individuals with Lateral Elbow Pain experiencing post-needling discomfort. Further research is necessary to fully elucidate the clinical implications of these findings.
The use of dry needling (DN) with other treatments may be more beneficial in managing post-stroke spasticity. We report the effects of DN plus exercise therapy (ET) on wrist flexor spasticity.
The ...patient was a 45-year-old man with an 8-year history of stroke. The outcome measures included the Modified Modified Ashworth Scale (MMAS), Hmax/Mmax ratio, H-reflex latency, Action Research Arm Test (ARAT), Fugl-Meyer Assessment (FMA), and range of motion (ROM) which were assessed before (T1), after (T2), and after 3-week follow-up (T3).
The MMAS was improved at T2 from “3” to “2”. The Hmax/Mmax decreased from 0.77 to 0.53 at T3. The H-reflex latency increased from 15.4 ms to 18.5 ms at T3. The wrist active and passive ROM increased ∼30° and ∼20° at T2, respectively.
A 4-session DN plus ET may improve spasticity and ROM. No meaningful improvement was observed in function.
•Dry needling (DN) with exercise therapy (ET) can reduce the wrist flexor spasticity after stroke.•Wrist ROM can increase after DN plus ET.•DN plus ET may have no clinically meaningful effect on function.
Key Clinical Message
The use of DN to the muscular trigger points and distal periosteal enthesis of the levator scapulae may be a useful adjunct intervention within a multi‐modal plan of care for the ...management of work‐related chronic tension‐type headaches associated with LSS.
Chronic tension‐type headaches (CTTH) have a lifetime prevalence of 42% and account for more lost workdays than migraine headaches. Dry needling (DN) is being increasingly used by physical therapists in the management of CTTH; however, to date, the supporting evidence is limited. The purpose of this case report was to describe how three sessions of DN targeting myofascial trigger points in the levator scapulae (LS) muscle and its distal enthesis was used to treat a 63‐year‐old male patient who presented with work‐related CTTH associated with levator scapulae syndrome (LSS). The patient was treated for five visits over the course of 2 months. At discharge and 6‐month follow‐up, the patient reported full resolution of symptoms. Self‐report outcomes included the numeric pain rating scale and the Neck Disability Index. The use of DN to the LS muscle and its distal enthesis may be a valuable addition to a multi‐modal plan of care in the treatment of work‐related CTTH associated with LSS.
Dry needling to the levator scapulae muscle and its distal enthesis in the management of chronic tension‐type headache.
We aimed to compare the efficacy of dry needling, trigger point injection, and protection methods through physical exercise on clinical symptoms and the pain threshold in patients with ...temporomandibular myofascial pain.
Between March 2013 and September 2013, in a random consecutive manner, a total of 63 consecutive patients (10 males, 53 females; median age 39.4±14.9 years; range, 18 to 65 years) were randomly divided into three groups: Group 1 (only exercise and protection training), Group 2 (dry needling + exercise + protection training), and Group 3 (trigger point injection + exercise + protection training). Dry needling or trigger point injection was performed for three times to the patients in Group 2 and Group 3 on a weekly basis. All patients were followed on Day 10 and at one month.
A statistically significant improvement in the assessment and response variables was found for all groups, particularly for pain and functional limitation status (p<0.001). All groups were similar in terms of the improvement degree (p<0.001). Although not statistically significant, the highest improvement in the facial pain was seen in Group 3 on Day 10 (p=0.235); however, on Day 30, no significant difference was observed.
Our study results showed that improvement in the subjective and objective symptoms in all treatment groups. Particularly, only exercise therapy was found to be beneficial as invasive methods. We suggest that all these methods should be applied together to achieve long-term efficacy.
Post-operative range of motion (ROM) loss and pain can limit quality of life, prolong functional return to activity, and may be sport/career threatening. Dry needling (DN) is intended assist in the ...treatment of these complaints.
To determine if the addition of upper quarter DN to a rehabilitation protocol is more effective in improving ROM, pain, and functional outcome scores when compared to a rehabilitation protocol alone after shoulder stabilization surgery.
Single-Blind Randomized Clinical Trial.
Thirty-nine post-operative shoulder patients were randomly allocated into two groups: (1) standard of care rehabilitation (control group) (2) standard of care rehabilitation plus dry needling (experimental group). Patient's pain, ROM, and functional outcome scores were assessed at baseline (4 weeks post-operative), and at 8 weeks, 12 weeks, and 6 months post-operative.
Of 39 enrolled patients, 20 were allocated to the control group and 19 to the experimental group. At six-month follow up, there was a statistically significant improvement in shoulder flexion ROM in the control group. Aside from this, there were no significant differences in outcomes between the two treatment groups. Both groups showed improvement over time. No adverse events were reported.
Dry needling of the shoulder girdle in addition to standard of care rehabilitation after shoulder stabilization surgery did not significantly improve shoulder ROM, pain, or functional outcome scores when compared with standard of care rehabilitation alone. Both group's improvement was largely equal over time. The significant difference in flexion at the six-month follow up may be explained by additional time spent receiving passive range of motion (PROM) in the control group. These results provide preliminary evidence that dry needling in a post-surgical population is safe and without significant risk of iatrogenic infection or other adverse events.
Therapy, Level 2.
This study aims to determine the effectivity of dry needling added to the standard treatment to improve pain in patients with upper trapezius myalgia.
This study is a randomized controlled trial ...conducted at Inco Hospital, Sorowako, South Sulawesi, Indonesia, involving 20 subjects who met the inclusion and exclusion criteria. Subjects were divided into two equal groups. The intervention group was treated with dry needling as the addition to standard care, and the control group was treated with standard care only. Both groups were treated three times a week for five weeks. The pain was measured using NPRS at baseline and after three times therapy for five weeks.
At the end of therapy, both groups showed a decrease in pain perception compared to baseline. The pain was improved significantly better in the intervention group compared to the control group.
The addition of dry needling in the standard care of upper trapezius myalgia resulted in more effective pain improvement compared to usual care.
Objective
To evaluate whether autologous conditioned plasma offers any therapeutic advantage over ultrasound-guided dry needling as a stand-alone procedure in the treatment of refractory lateral ...epicondylitis.
Materials and methods
Prospective, randomized pilot study of 28 patients (11 men, 17 women, mean age, 49.1 years) with refractory lateral epicondylitis (mean symptom duration, 19.1 months) who underwent either dry needling (
n
= 13) or dry needling combined with autologous conditioned plasma (ACP) injection (
n
= 15). Each patient received two separate injections (0 weeks and 1 month) and analysis of visual analogue pain scores (VAS) and Nirschl scores were performed pre-procedure, at 2 months and final evaluation at 6 months. Successful treatment was defined as more than a 25 % reduction in pain scores without re-intervention. Data was analyzed using the Mann–Whitney test and local research ethics committee approval was obtained.
Results
At 2 months, the mean VAS improvement was 0.85 (12.3 %) in the dry needling group compared to 2.19 (27.1 %) in the ACP group (
p
= 0.76) and there was a 5.83-point and 20.3-point Nirschl score improvement respectively (
p
= 0.72). At the final follow-up of 6 months, the mean VAS improvement was 2.37 (34 %) in the dry needling group compared to 3.92 (48.5 %) in the ACP group (
p
= 0.74) and there was a 22.5-point and 40-point Nirschl score improvement, respectively (
p
= 0.82).
Conclusions
There is a trend to greater clinical improvement in the short term for patients treated with additional ACP, however no significant difference between the two treatment groups was demonstrated at each follow-up interval. A larger, multicenter, randomized controlled trial is required to corroborate the results of this pilot study.
This study examined the effects of dry needling on chronic heel pain due to plantar fasciitis.
During this single-blinded clinical trial, 20 eligible patients were randomized into two groups: A case ...group treated with dry needling and a control group. Patients' plantar pain severity, (using modified visual analog scale VAS scoring system), range of motion of ankle joint in dorsiflexion ROMDF and plantar extensionROMPE and foot function index (using standard questionnaires of SEM5 and MDC7) were assessed at baseline, four weeks after intervention and four weeks after withdrawing treatment. Independent sample t-test, Mann-Whitney U test, paired t-test, Wilcoxon signed rank tests, and chi square test were used for data analysis.
The mean VAS scores in the case group was significantly lower than the control group after four weeks of intervention (p<0.001). Comparison of the ROMDF and ROMPE did not reveal any significant changes after four weeks of intervention in the case and control groups (p=0.7 and p=0.65, respectively). The mean of MDC7 and SEM5 scores in the case group were significantly lower than the control group following four weeks of intervention (p<0.001).
Despite the insignificant effect on ROMDF and ROMPE, trigger point dry needling, by improving the severity of heel pain, can be used as a good alternative option before proceeding to more invasive therapies of plantar fasciitis.
Tension-type headache is the most prevalent type of headache and is commonly associated with myofascial pain syndrome and the presence of active myofascial trigger points. This randomized controlled ...trial aimed to assess the impact of dry needling on the total number of active trigger points, pain intensity, and perceived clinical change in tension-type headache subjects. Thirty-two subjects were randomly assigned to the control and dry needling groups. The presence of active trigger points in 15 head and neck muscles, the headache intensity, and the perceived clinical change were evaluated. A single dry needling technique was administered at each active trigger point across three sessions. Significant differences were observed in the post-treatment measures favouring the dry needling group, including reductions in the headache intensity scores (
= 0.034) and the total number of active trigger points (
= 0.039). Moreover, significant differences in the perception of clinical change were found between the control and treatment groups (
= 0.000). Dry needling demonstrated positive effects in reducing the number of active trigger points and improving the short-term headache intensity in tension-type headache patients. A single dry needling session applied in the cranio-cervical area resulted in a self-perceived improvement compared to the control subjects.
Purpose: Fu’s subcutaneous needling (FSN) is a new acupuncture technique that produces a long-lasting effect in soft-tissue injuries. In patients with degenerative knee osteoarthritis (OA), ...myofascial trigger points (MTrPs) are common in the lower-limb muscles. In this randomized clinical trial, we evaluated the immediate, 1-week and 2-week effectiveness of FSN therapy in the treatment of degenerative knee OA. Patients and methods: We randomly divided 32 patients with knee OA into the FSN group (mean age: 65.73 ± 6.79 years) or the transcutaneous electrical nerve stimulation (TENS) group (mean age: 62.81 ± 5.72 years). The pressure pain threshold (PPT) and tissue hardness (TH) of the muscle and tendon attachment sites, knee range of motion, and physical ability (average walking speed) were measured. The subjective pain intensity index, Western Ontario and McMaster Universities OA Index (WOMAC), and Lequesne index were used to determine the efficacy of FSN on MTrP-induced soft-tissue pain compared with that of TENS. Results: A significantly greater improvement in pain qualities in the VAS (p < 0.05) was found in the FSN group. Moreover, in muscle and tendon qualities (including PPT and TH), a significant difference in the PPT of the quadriceps muscle (p < 0.05) was also observed among the immediate treatments in the FSN group. As for the functional index questionnaire assessment, the FSN group exhibited significant improvements among the immediate, 1-week and 2-week efficacies in terms of WOMAC (p < 0.05) and Lequesne index scores (p < 0.05). Conclusion: FSN was effective in treating soft-tissue pain in degenerative knee OA in terms of alleviating pain, strengthening walking ability, and improving overall functional performance. Pain relief was the primary benefit of FSN and a significant correlation between pain relief and knee joint mobility improvement was found. Trial registration: ClinicalTrials.gov Protocol Registration and Results System (registration number: NCT04356651).
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