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Context: Hamstring muscle tightness is one of the most common problems in athletic and healthy people. Dry needling (DN) was found to be an effective approach for improving muscle flexibility, but there is no study to compare this approach with static stretching (SS) as a common technique for the increase of muscle length. Objective: To compare the immediate effects of DN and SS on hamstring flexibility in healthy subjects with hamstring tightness. Study Design: A single-blind randomized controlled trial. Setting: A musculoskeletal physiotherapy clinic at Tehran University of Medical Sciences. Subjects: Forty healthy subjects (female: 32, age range: 18–40 y) with hamstring tightness were randomly assigned into 2 groups of DN and SS. Intervention: The DN group received a single session of DN on 3 points of the hamstring muscles, each for 1 minute. The SS group received a single session of SS of the hamstrings, consisting of 3 sets of 30-second SS with a 10-second rest between sets in the active knee extension test (AKET) position. Main Outcome Measures: The AKET, muscle compliance, passive peak torque, and stretch tolerance were measured at the baseline, immediately, and 15 minutes after the interventions. Results: Improvements in all outcomes was better for the DN group than for the SS group. DN increased muscle compliance significantly 15 minutes after the intervention, but it did not improve in the SS group. Conclusion: DN is effective in improving hamstring flexibility compared with SS. One session of DN can be an effective treatment for hamstring tightness and increase hamstring flexibility. The improvements suggest that DN is a novel treatment for hamstring flexibility.

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Objective Dry needling is a treatment technique used by clinicians to relieve symptoms in patients with tension-type headache (TTH), cervicogenic headache (CGH), or migraine. This systematic review's main objective was to assess the effectiveness of dry needling on headache pain intensity and related-disability in patients with TTH, CGH, or migraine. Methods Medline/PubMed, Scopus, Embase®, PEDro, WoS, Ovid, AMED/EBSCO, CENTRAL, Google Scholar, and trial registries were searched until April 1, 2020, along with reference lists of eligible studies and related reviews. Randomized clinical trials or observational studies that compared the effectiveness of dry needling with any other interventions were eligible for inclusion. Three reviewers independently selected studies, extracted data, and assessed risk of bias. Random-effects meta-analyses were performed to produce pooled-effect estimates (Morris’s dppc2) and their respective confidence intervals. Results Of 2715 identified studies, 11 randomized clinical trials were eligible for qualitative synthesis and 9 for meta-analysis. Only four trials were of high quality. Very low-quality evidence suggested that dry needling is not statistically better than other interventions for improving headache pain intensity at short-term in patients with TTH (SMD −1.27, 95% CI −3.56 to 1.03, n = 230), CGH (SMD −0.41, 95% CI −4.69 to 3.87, n = 104), or mixed headache (TTH and migraine; SMD 0.03; 95% CI −0.42 to 0.48, n = 90). Dry needling provided significantly greater improvement in related-disability at short-term in patients with TTH (SMD −2.28, 95% CI −2.66 to −1.91, n = 160) and CGH (SMD −0.72, 95% CI −1.09 to −0.34, n = 144). The synthesis of results showed that dry needling could significantly improve headache frequency, health-related quality of life, trigger point tenderness, and cervical range of motion in TTH and CGH. Conclusions Dry needling produces similar effects to other interventions for short-term headache pain relief, whereas dry needling seems to be better than other therapies for improvement in related-disability in the short-term. Impact Although further high methodological quality studies are warranted to provide a more robust conclusion, our systematic review suggested that for every one to two patients with TTH treating by dry needling, one patient will likely show decreased headache intensity (NNT = 2; large effect) and improved related-disability (NNT = 1; very large effect). In CGH, for every three to four patients treating by dry needling, one patient will likely exhibit decreased headache intensity (NNT = 4; small effect) and improved related-disability (NNT = 3; medium effect).

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