Trigger points are composed of multiple tight contraction knots within the muscle which cause and contribute to pain within the body. Acupuncture and dry-needling for low back pain. Very low–quality to moderate quality evidence suggests that dry needling performed by physical therapists is more effective than no treatment, sham dry needling, and other treatments for reducing pain and improving pressure pain threshold in patients presenting with musculoskeletal pain in the immediate to 12-week follow-up period. Heterogeneity was high (I2 = 78%). 14, No. 1173185, Dommerholt, J., Del Morel, O. and Grobli, C. Trigger point dry needling. The database search returned a total of 218 articles after duplicates were removed. Acupuncture technique does not aim to necessarily even pierce muscle tissue, nor cause this important muscle twitch response that is definitive of Dry Needling. In most cases Physiopedia articles are a secondary source and so should not be used as references. This systematic review has some limitations. However, no difference in functional outcomes exists when compared to other physical therapy treatments. Although findings of this review provide very low- to moderate-quality evidence for the effectiveness of dry needling for reducing pain and improving PPT when compared to other physical therapy interventions during the immediate to 12-week follow-up period, the small effect sizes and the varied study populations and comparison interventions utilized do not support a strong recommendation of dry needling over other physical therapy interventions. After appraising the evidence, each meta-analysis was classified as 1 of the following levels of evidence to support its findings14: Randomized controlled trials began with a high-quality evidence classification but were downgraded based on 5 domains: (1) study design and risk of bias (downgraded if greater than 25% of the participants were from studies with a high risk of bias, which we defined as PEDro scale scores of less than 6); (2) inconsistency of results (downgraded if significant heterogeneity was present on visual inspection or the I2 value was greater than 50%); (3) indirectness (generalizability of the findings downgraded if greater than 50% of the participants were outside the target group); (4) imprecision (downgraded if fewer than 400 participants were included in the comparison for continuous data); and (5) other (publication bias).37 We reduced the quality of evidence by 1 level for each domain not met in the comparison to determine the overall quality rating of the evidence for each meta-analysis performed. Now by omitting unnecessary medication (and side effects), Dry Needling has established itself as a treatment that is minimally invasive, cost effective and carries a low risk. 2, Journal of Sport Rehabilitation, Vol. This occurs 7-10 days after dry needling. 33, No. While research indicates dry needling is a safe and effective approach for treating and managing pain, some insurance companies may not reimburse for the procedure. J Am Board Fam Med. This improves the generalizability of our findings to physical therapists, and provides evidence that dry needling may be an effective treatment technique when used by physical therapists trained in its use in an appropriate patient for the management of musculoskeletal pain. After screening, 13 were included. The risk of bias within studies was assessed with PEDro scale scores (TABLE 2). 28, No. 3, Brazilian Journal of Physical Therapy, Vol. 41, No. Identification of myofascial trigger points in the muscle through palpation, Deep dry needling reproduces the patient's pattern of pain, Identification of 'Jump' and 'Shout' sign on palpation on MTrP. 15, No. 32, No. Guidelines for safe acupuncture and dry needling practice, 2007. There is low-quality evidence suggesting a small effect8 (SMD, −0.44; 95% CI: −0.85, −0.04) favoring dry needling over control/sham. There is very low-quality evidence suggesting a moderate effect (SMD, 0.61; 95% CI: 0.08, 1.14) favoring dry needling over other treatment. 42 Dry needling is often used to treat myofascial trigger points (MTrPs), which are described as localized hypersensitive spots in a palpable taut band of muscle. These hyperirritable spots can be classified as active MTrPs when they produce spontaneous pain and, when palpated, reproduce a patient's familiar pain. The PEDro scale has been shown to have fair to good interrater reliability, with an intraclass correlation coefficient of 0.55 (95% confidence interval [CI]: 0.41, 0.72)26 and higher scores indicating higher methodological quality. Future randomized clinical trials should further investigate the effectiveness of this protocol under similar conditions. Previous reviews have commonly focused on a specific anatomical region rather than the entire body,20,23,30,31 and have not examined the effectiveness of dry needling applied by a single health professional.
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