Effectiveness of dry needling in the treatment of neck pain and disability associated with myofascial trigger points

Year 2021, Volume: 34 Issue: 1, 40 - 44, 29.01.2021

Canan Sanal Toprak Tugba Ozsoy Unubol

https://doi.org/10.5472/marumj.866557

Cited By: 1

Abstract

Objective: The aim of this study is to evaluate the effectiveness of dry needling (DN) with fast-in and fast-out technique for myofascial
trigger points (MTrPs) in the upper trapezius muscle associated with neck pain.
Patients and Methods: Patients aged 18-70 years, who have had neck pain at least one active MTrP in the upper trapezius muscle
treated with DN, were included in the study. Pain and disability were assessed with Numeric Rating Scale (NRS) and Neck Disability
Index (NDI) before treatment (T0), after first session (T1) and after last session (T2). Number of MTrPs where DN was performed
and the number of DN sessions were recorded. Patients were evaluated based on the minimal clinically important change (MCIC)
scores for NRS and NDI.
Results: A total of 76 patients (Female: 67, Male: 9) were included in the study. Median number of DN sessions was 3 and median of
MTrPs that DN performed was 4. Both NRS and NDI showed significant improvement at T1 and T2. More than 90% of patients had
MCIC at T1 and T2.
Conclusion: Dry needling with fast-in and fast-out technique is effective for pain and disability management in patients with neck
pain due to MTrPs.

Keywords

Dry needling, Myofascial trigger points, Neck pain, Neck disability

References

• Navarro-Santana MJ, Sanchez-Infante J, Fernández-de-Las- Peñas C, et al. Effectiveness of dry needling for myofascial trigger points associated with neck pain symptoms: An updated systematic review and meta-analysis. J Clin Med 2020;9: 3300. doi: 10.3390/jcm9103300
• Shah JP, Thaker N, Heimur J, et al. Myofascial trigger points then and now: a historical and scientific perspective. PM&R 2015:7: 746-61. doi: 10.1016/j.pmrj.2015.01.024
• Climent JM, Kuan T-S, Fenollosa P, et al. Botulinum toxin for the treatment of myofascial pain syndromes involving the neck and back: a review from a clinical perspective. Evid Based Complement Alternat Med 2013:2013. doi: 10.1155/2013/381459
• Cagnie B, Dewitte V, Barbe T, et al. Physiologic effects of dry needling. Curr Pain Headache Rep 2013;17: 348. doi: 10.1007/ s11916.013.0348-5
• Shah JP, Danoff JV, Desai MJ, et al. Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points. Arch Phys Med Rehabil 2008;89: 16-23. doi: 10.1016/j.apmr.2007.10.018
• Unverzagt C, Berglund K, Thomas J. Dry needling for myofascial trigger point pain: a clinical commentary. Int J Sports Phys Ther 2015;10: 402-18.
• Fernández-de-Las-Peñas C, Nijs J. Trigger point dry needling for the treatment of myofascial pain syndrome: current perspectives within a pain neuroscience paradigm. J Pain Res 2019;12: 1899-1911. doi: 10.2147/JPR.S154728
• Pecos-Martín D, Montañez-Aguilera FJ, Gallego-Izquierdo T, et al. Effectiveness of dry needling on the lower trapezius in patients with mechanical neck pain: a randomized controlled trial. Arch Phys Med Rehabil 2015;96: 775-81. doi: 10.1016/j. apmr.2014.12.016
• Dommerholt J. Dry needling—peripheral and central considerations. J Man Manip Ther 2011;19: 223-7. doi: 10.1179/106698111X131.297.29552065
• Dunning J, Butts R, Mourad F, et al. Dry needling: a literature review with implications for clinical practice guidelines. Phys Ther Rev 2014;19: 252-65. doi: 10.1179/108331913X138.442.45102034
• Tsai C-T, Hsieh L-F, Kuan T-S, et al. Remote effects of dry needling on the irritability of the myofascial trigger point in the upper trapezius muscle. Am J Phys Med Rehabil 2010;89: 133-40. doi: 10.1097/PHM.0b013e3181a5b1bc
• Liu L, Huang Q-M, Liu Q-G, et al. Effectiveness of dry needling for myofascial trigger points associated with neck and shoulder pain: a systematic review and meta-analysis. Arch Phys Med Rehabil 2015;96: 944-55. doi: 10.1016/j. apmr.2014.12.015
• Aslan E, Karaduman A, Yakut Y, et al. The cultural adaptation, reliability and validity of neck disability index in patients with neck pain: a Turkish version study. Spine 2008;33: E362-E365. doi: 10.1097/BRS.0b013e31817144e1
• Cleland JA, Fritz JM, Whitman JM, et al. The reliability and construct validity of the Neck Disability Index and patient specific functional scale in patients with cervical radiculopathy. Spine 2006;31: 598-602. doi: 10.1097/01. brs.000.020.1241.90914.22
• Pool JJ, Ostelo RW, Hoving JL, et al. Minimal clinically important change of the Neck Disability Index and the Numerical Rating Scale for patients with neck pain. Spine 2007;32: 3047-51.doi: 10.1097/BRS.0b013e31815cf75b
• Simons DG, Travell J, Simons LS. Myofascial pain and dysfunction: the trigger point manual. Volume 1. Baltimore: Williams and Wilkins, 1999.
• Hong C-Z. Considerations and recommendations regarding myofascial trigger point injection. J Musculoskelet Pain 1994;2: 29-59.doi: 10.1300/J094v02n01_03
• Tekin L, Akarsu S, Durmuş O, et al. The effect of dry needling in the treatment of myofascial pain syndrome: a randomized double-blinded placebo-controlled trial. Clin Rheumatol 2013;32: 309-15.doi: 10.1007/s10067.012.2112-3
• Onat SS, Polat CS, Bicer S, et al. Effect of dry needling injection and kinesiotaping on pain and quality of life in patients with mechanical neck pain. Pain physician 2019;22: 583-9.
• Cagnie B, Castelein B, Pollie F, et al. Evidence for the use of ischemic compression and dry needling in the management of trigger points of the upper trapezius in patients with neck pain: a systematic review. Am J Phys Med Rehabil 2015;94: 573-83.doi: 10.1097/PHM.000.000.0000000266
• Cerezo-Téllez E, Torres-Lacomba M, Fuentes-Gallardo I, et al. Effectiveness of dry needling for chronic nonspecific neck pain: a randomized, single-blinded, clinical trial. Pain 2016;157: 1905-17.doi: 10.1097/j.pain.000.000.0000000591
• Gallego-Sendarrubias GM, Rodríguez-Sanz D, Calvo-Lobo C, et al. Efficacy of dry needling as an adjunct to manual therapy for patients with chronic mechanical neck pain: a randomised clinical trial. Acupunct Med 2020; acupmed-2018-011682. doi: 10.1097/AJP.000.000.0000000634
• Ziaeifar M, Arab AM, Mosallanezhad Z, et al. Dry needling versus trigger point compression of the upper trapezius: a randomized clinical trial with two-week and threemonth follow-up. J Man Manip Ther 2019;27: 152-161. doi: 10.1080/10669.817.2018.1530421
• Kietrys DM, Palombaro KM, Azzaretto E, et al. Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis. J Orthop Sports Phys Ther 2013;43: 620-634. doi: 10.2519/jospt.2013.4668
• Nunes AMP, Moita JPAM. Effectiveness of physical and rehabilitation techniques in reducing pain in chronic trapezius myalgia: A systematic review and meta-analysis. Int J Osteopath Med 2015;18: 189-206.doi: 10.1016/j. ijosm.2015.03.004
• Fernández-de-las-Peñas C, Dommerholt J. Myofascial trigger points: peripheral or central phenomenon? Curr Rheumatol Rep 2014;16: 395.doi: 10.1007/s11926.013.0395-2