Archives of Physical Medicine and Rehabilitation
01/12/2015
Evidence Based Medicine
Review Article
Liu L, et al. – This study aimed to evaluate current evidence on the effectiveness of dry needling for myofascial trigger points (MTrPs) associated with neck and shoulder pain. Dry needling can be recommended to relieve MTrP pain of neck and shoulders in short and medium terms, but wet needling is more effective than dry needling in reducing MTrP pain in neck and shoulders in medium term.
Effectiveness of Dry Neeedling for Myofascial Trigger Points Associated with Neck and Shoulder Pain: A Systematic Review and Meta-analysis
Lin Liu, MSc
Received: October 15, 2014; Received in revised form: December 28, 2014; Accepted: December 29, 2014; Published Online: January 07, 2015
Abstract
Objective
This study aimed to evaluate current evidence on the effectiveness of dry needling for myofascial trigger points (MTrPs) associated with neck and shoulder pain.
Data Sources
PubMed, EBSCO, Physiotherapy Evidence Database, ScienceDirect, The Cochrane Library, Clinical Key, Wangfang Data, CNKI, Chinese VIP Information, and Springer Link databases were searched from database inception to January 2014.
Study Selection
Randomized controlled trials (RCTs) were performed to determine if dry needling was used as main treatment and if pain intensity was included as an outcome. Participants were diagnosed with MTrPs associated with neck and shoulder pain.
Data extraction
Two reviewers independently screened the articles, scored methodological quality, and extracted data. Results regarding pain intensity were extracted in the form of mean and standard deviation data. Twenty RCTs involving 839 patients were obtained for meta-analysis.
Data Synthesis
Meta-analyses were performed using RevMan 5.2 and Stata 12.0. Results suggested that compared with control/sham group, dry needling to MTrPs was effective in short term [SMD=−1.91, 95% CI (−3.10, −0. 73), P=0.002] and medium term [SMD=−1.07, 95% CI (−1.87, −0.27), P=0.009]; however, wet needling (including lidocaine) was superior to dry needling in relieving MTrP pain in medium term [SMD=1.69, 95% CI (0.40, 2.98), P=0.01]. Other therapies (including physiotherapy) were more effective than dry needling to treat MTrP pain in medium term [SMD=0.62, 95% CI (0.02, 1.21), P=0.04].
Conclusions
Dry needling can be recommended to relieve MTrP pain of neck and shoulders in short and medium terms, but wet needling is more effective than dry needling in reducing MTrP pain in neck and shoulders in medium term (9 days to 28 days).