Comparison of immediate and delayed effects of superficial and deep dry needling in patients with upper trapezius myofascial trigger points

Dry needling as an adjunct treatment to multimodal rehabilitation protocol following rotator cuff repair surgery: a preliminary, randomized sham-controlled trial

BACKGROUND

Rotator cuff repair (RCR) is one of the most prevalent procedures to manage rotator cuff tears (RCT). Postoperative shoulder pain is a common complication following RCR and may be aggravated by activation of myofascial trigger points (MTrP) associated with the injury to the soft tissues surrounding the surgical incision. This study aimed to describe a preliminary, randomized, sham-controlled trial to evaluate the effectiveness of implementing 4 sessions of myofascial trigger point dry needling (MTrP-DN) as a muscle treatment approach along with 10 sessions of multimodal rehabilitation protocol (MRh) consisting of therapeutic exercise, manual therapy, and electrotherapy on postoperative shoulder pain, range of motion (ROM), strength, and functional outcome scores for patients following RCR surgery.

METHODS

Forty-six patients aged 40-75 following RCR surgery were recruited and randomly allocated into 2 groups: (1) MTrP-DN plus MRh (experimental group), and (2) sham dry needling (S-DN) plus MRh (control group). This trial had a 4-week intervention period. The primary outcome was the Numeric Pain Rating Scale (NPRS) for postoperative shoulder pain. Secondary outcomes were the Shoulder Pain and Disability Index (SPADI), ROM, and strength. The mentioned outcomes were measured at baseline and week 4. In the current study, adverse events were recorded as well.

RESULTS

No statistically significant differences were observed between groups when adding MTrP-DN to MRh for postoperative shoulder pain after 4 weeks of intervention (mean difference 0.32, [95% CI -0.41,1.05], p = 0.37). However, this trial found a small effect size for postoperative shoulder pain. No significant between-group differences were detected in any of the secondary outcomes (p > 0.05) either. We found significant within-group changes in all studied outcome measures. (p < 0.001). This study also reported minor adverse events. following the needling approach.

CONCLUSION

The lack of statistically significant differences in the outcomes and small clinical significance in shoulder pain highlights the complexity of pain management, suggesting that alternative methodologies may be needed for meaningful clinical benefits. Future studies should consider different control groups, long-term follow ups, larger sample sizes, and more MTrP-DN sessions to better understand their potential impact.

TRIAL REGISTRATION

This trial was registered at ( https://www.irct.ir ), (IRCT20211005052677N1) on 19/02/2022.

Research Trends in Dry Needling for Neck Pain Treatment: A Bibliometric Analysis

Objective

The objective of this study was to analyze the published literature on the utilization of dry needling in the management of neck pain.

Methods

We performed a bibliometric analysis of publications from January 1, 2002 to December 31, 2022. Using the Scopus database, articles about the utilization of dry needling in neck pain were found. Scopus analyzer was used to obtain results such as "documents by year," "source," "country," and so on. VOS viewer Version 1.6.18 was used to analyze various units such as "co-authorship," "co-occurrences," and "citation analysis."

Results

The search yielded 125 articles. Most articles were published in the years 2022, followed by 2021. A network analysis of various parameters reveals that the topic has a high research potential.

Conclusion

This bibliometric analysis offers an understanding of the literature on dry needling therapy for neck pain. The number of studies in this sector has increased over a decade. There is a gap in research from low- and middle-income countries on use of dry needling in the management of neck pain.

Comparison of Dry Needling and Cold-Spray-Stretching Treatments by Ultrasonography and Electrophysiology: Prospective, Randomized Controlled Trial

OBJECTIVES

To compare the efficacy of dry needling (DN) and cold-spray-stretching treatments using surface electromyography (sEMG) and ultrasound (US) in the treatment of patients with myofascial pain syndrome (MPS) with active trigger point (ATrP) in the upper trapezius muscle.

METHODS

This prospective randomized single-blind study included 60 MPS patients aged 18-65 years who have ATrP in the upper trapezius muscle. Patients were randomized into two treatment groups as DN and cold spray stretching. Both treatment groups received 1 treatment per week and totally 3 sessions. Evaluation parameters were pain level assessed by Numeric Rating Scale and algometer, neck range of motion angles, neck disability index (NDI). The effects of the treatments on ATrP were evaluated by sEMG and US histogram. All parameters were evaluated at the beginning of the treatment and at the end. Algometer and sEMG were performed also before and after the first and third sessions.

RESULTS

There was no significant difference between the two groups regarding demographic data. The mean age of the participants was 39.7 ± 11.6 years. Fifty-one patients were female. Significant improvement in terms of pain level, functionality, sEMG, and US histogram were achieved in both groups (P < .05). When comparing the two groups, algometer scores and the NDI score were statistically higher in the cold-spray-stretching group than in the DN group (P < .008 and P < .028, respectively).

CONCLUSION

Both treatment options should be preferred. The efficacy of both treatments was observed via sEMG and US histograms.