Dry Needling Alters Trigger Points in the Upper Trapezius Muscle and Reduces Pain in Subjects With Chronic Myofascial Pain
- PMID:25661462
- PMCID: PMC4508220
- DOI: 10.1016/j.pmrj.2015.01.020
Dry Needling Alters Trigger Points in the Upper Trapezius Muscle and Reduces Pain in Subjects With Chronic Myofascial Pain
Abstract
Objective: To determine whether dry needling of an active myofascial trigger point (MTrP) reduces pain and alters the status of the trigger point to either a non-spontaneously tender nodule or its resolution.
Design: A prospective, nonrandomized, controlled, interventional clinical study.
Setting: University campus.
Participants: A total of 56 subjects with neck or shoulder girdle pain of more than 3 months duration and active MTrPs were recruited from a campus-wide volunteer sample. Of these, 52 completed the study (23 male and 33 female). Their mean age was 35.8 years.
Interventions: Three weekly dry needling treatments of a single active MTrP.
Primary outcomes: Baseline and posttreatment evaluations of pain using a verbal analogue scale, the Brief Pain Inventory, and the status of the MTrP as determined by digital palpation. Trigger points were rated as active (spontaneously painful), latent (requiring palpation to reproduce the characteristic pain), or resolved (no palpable nodule).
Secondary outcomes: Profile of Mood States, Oswestry Disability Index, and Short Form 36 scores, and cervical range of motion.
Primary outcomes: A total of 41 subjects had a change in trigger point status from active to latent or resolved, and 11 subjects had no change (P < .001). Reduction in all pain scores was significant (P < .001).
Secondary outcomes: Significant improvement in posttreatment cervical rotational asymmetry in subjects as follows: unilateral/bilateral MTrPs (P = .001 and P = 21, respectively); in pain pressure threshold in subjects with unilateral/bilateral MTrPs, (P = .006 and P = .012, respectively); improvement in the SF-36 mental health and physical functioning subscale scores (P = .019 and P = .03), respectively; and a decrease in the Oswestry Disability Index score (P = .003).
Conclusions: Dry needling reduces pain and changes MTrP status. Change in trigger point status is associated with a statistically and clinically significant reduction in pain. Reduction of pain is associated with improved mood, function, and level of disability.
Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
Figures
Comment in
- Ask the Authors.Prather H, Gerber LH, Shah J, Sikdar S.Prather H, et al.PM R. 2015 Jul;7(7):719-720. doi: 10.1016/j.pmrj.2015.06.009.PM R. 2015.PMID:26188778No abstract available.
- Re: "Dry Needling Alters Trigger Points in the Upper Trapezius Muscle and Reduces Pain in Subjects with Chronic Myofascial Pain".Miles D.Miles D.PM R. 2016 Dec;8(12):1225-1226. doi: 10.1016/j.pmrj.2016.07.533.PM R. 2016.PMID:27989419No abstract available.
- Reply.Shah J, Sikdar S, Gerber L.Shah J, et al.PM R. 2016 Dec;8(12):1226-1227. doi: 10.1016/j.pmrj.2016.08.003.PM R. 2016.PMID:27989420No abstract available.
Similar articles
- Beneficial Effects of Dry Needling for Treatment of Chronic Myofascial Pain Persist for 6 Weeks After Treatment Completion.Gerber LH, Sikdar S, Aredo JV, Armstrong K, Rosenberger WF, Shao H, Shah JP.Gerber LH, et al.PM R. 2017 Feb;9(2):105-112. doi: 10.1016/j.pmrj.2016.06.006. Epub 2016 Jun 11.PM R. 2017.PMID:27297448Free PMC article.
- A systematic comparison between subjects with no pain and pain associated with active myofascial trigger points.Gerber LH, Sikdar S, Armstrong K, Diao G, Heimur J, Kopecky J, Turo D, Otto P, Gebreab T, Shah J.Gerber LH, et al.PM R. 2013 Nov;5(11):931-8. doi: 10.1016/j.pmrj.2013.06.006. Epub 2013 Jun 28.PM R. 2013.PMID:23810811Free PMC article.
- Postneedling soreness after deep dry needling of a latent myofascial trigger point in the upper trapezius muscle: Characteristics, sex differences and associated factors.Martín-Pintado-Zugasti A, Rodríguez-Fernández ÁL, Fernandez-Carnero J.Martín-Pintado-Zugasti A, et al.J Back Musculoskelet Rehabil. 2016 Apr 27;29(2):301-308. doi: 10.3233/BMR-150630.J Back Musculoskelet Rehabil. 2016.PMID:26406209
- Effectiveness of dry needling for myofascial trigger points associated with neck and shoulder pain: a systematic review and meta-analysis.Liu L, Huang QM, Liu QG, Ye G, Bo CZ, Chen MJ, Li P.Liu L, et al.Arch Phys Med Rehabil. 2015 May;96(5):944-55. doi: 10.1016/j.apmr.2014.12.015. Epub 2015 Jan 7.Arch Phys Med Rehabil. 2015.PMID:25576642Review.
- 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.Cagnie B, Castelein B, Pollie F, Steelant L, Verhoeyen H, Cools A.Cagnie B, et al.Am J Phys Med Rehabil. 2015 Jul;94(7):573-83. doi: 10.1097/PHM.0000000000000266.Am J Phys Med Rehabil. 2015.PMID:25768071Review.
Cited by
- A Targeted Approach to Post-Mastectomy Pain and Persistent Pain following Breast Cancer Treatment.Chang PJ, Asher A, Smith SR.Chang PJ, et al.Cancers (Basel). 2021 Oct 16;13(20):5191. doi: 10.3390/cancers13205191.Cancers (Basel). 2021.PMID:34680339Free PMC article.Review.
- Acupuncture therapy on myofascial pain syndrome: a systematic review and meta-analysis.Xiong J, Zhou X, Luo X, Gong X, Jiang L, Luo Q, Zhang S, Jiang C, Pu T, Liu J, Zhang J, Li B, Chi H.Xiong J, et al.Front Neurol. 2024 May 3;15:1374542. doi: 10.3389/fneur.2024.1374542. eCollection 2024.Front Neurol. 2024.PMID:38765261Free PMC article.
- Rate and maintenance of improvement of myofascial pain with dry needling alone vs. dry needling with intramuscular electrical stimulation: a randomized controlled trial.Brennan K, Elifritz KM, Comire MM, Jupiter DC.Brennan K, et al.J Man Manip Ther. 2021 Aug;29(4):216-226. doi: 10.1080/10669817.2020.1824469. Epub 2020 Sep 29.J Man Manip Ther. 2021.PMID:32990529Free PMC article.Clinical Trial.
- The effects of dry needling on the thumb: A case report.Voss MR, Donnay RL, Homa JK.Voss MR, et al.Hong Kong J Occup Ther. 2021 Dec;34(2):132-136. doi: 10.1177/15691861211043687. Epub 2021 Dec 20.Hong Kong J Occup Ther. 2021.PMID:34987351Free PMC article.
- Multimodal Care in the Management of a Patient With Chronic Tendinopathy of the Biceps Femoris: A Case Report.Martin BR.Martin BR.J Chiropr Med. 2017 Jun;16(2):156-162. doi: 10.1016/j.jcm.2017.01.006. Epub 2017 Mar 18.J Chiropr Med. 2017.PMID:28559756Free PMC article.
References
- Tekin L, Akarsu S, Durmuş O, Cakar E, Dinçer U, Kıralp MZ. The effect of dry needling in the treatment of myofascial pain syndrome: a randomized double-blinded placebo-controlled trial. Clin Rheumatol. 2013;32(3):309–15. - PubMed
- Schade H. Untersuchungen in der Erkältungstrage: III. Uber den Rheumatismus, insbesondere den Muskelrheumatismus (myogelose) Müench Med Wochenschr. 1921;68:95–99.
Publication types
MeSH terms
Related information
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical