A randomized trial of trigger point dry needling versus sham needling for chronic tension-type headache

Abstract

Background: In this randomized, double-blind, parallel-group trial, we aimed to explore the effectiveness of trigger point dry needling in patients with chronic tension-type headache in reducing headache frequency, intensity and duration, and improvement of health-related quality of life. Methods: The 168 patients in 2 neurology clinics with chronic tension-type headache. The participants were randomly assigned to one of two treatment groups for dry needling or sham dry needling, delivered in 3 sessions a week for 2 weeks. The 160 patients fulfilled the study requirements. The dry needling was applied in active trigger points located in the musculature of the head and the neck. The patients received dry needling using sterile stainless-steel acupuncture needles of 0.25 × 40 mm and 0.25 × 25 mm dimensions. The sham dry needling procedure was applied into the adipose tissue located at any area where an active trigger point was absent. The primary outcome measurement was the headache intensity. Secondary outcomes were frequency and duration of headache, and quality of life, assessed by the Short Form-36. All outcomes were measured at baseline, at the end of 2-week, and 1-month follow-up period. Results: In the dry needling group, intensity, frequency and duration of headache, and the scores of Short Form-36 subscales were significantly improved after treatment ( P < .05). In the dry needling group, all the effect sizes for headache variables were large. Conclusions: The results of this clinical trial suggest that trigger point dry needling in patients with chronic tension-type headache is effective and safe in reducing headache intensity, frequency and duration, and increasing health-related quality of life. Trial registration: Clinical Trials NCT03500861.

Clinical Reasoning Behind Non-Pharmacological Interventions for the Management of Headaches: A Narrative Literature Review

“…Sedighi et al compared superficial (skin-biased) versus deep (muscle-biased) dry needing over the suboccipital and upper trapezius musculature in people with CeH and showed that both needling approaches were similarly effective for reducing headaches, but deep dry needling was more effective for improving function [55]. A recent randomized clinical trial found that real dry needling over active TrPs located in the neck and head musculature was more effective than sham needling for reducing headache pain parameters, e.g., intensity, frequency, and duration of headache, and for improving health-related quality of life in patients with chronic TTH [56]. Nevertheless, the number of sessions, muscles which should be needled, dosage, frequency of sessions, and long-term follow-ups are needed to further conclude a real effect of dry needling in primary headaches.…”

Effectiveness of dry needling for improving pain and disability in adults with tension-type, cervicogenic, or migraine headaches: protocol for a systematic review

“…TrPs can be defined as hyperirritable palpable spots of taut fibers located within a myofascial tissue, which have been known to cause non-dermatomal referral pain and discomfort [21]. Muscles which are commonly involved in tension-type headache include the sub-occipital, sternocleidomastoid, upper trapezius, levator scapula, splenius, temporalis, and masseter [14, 22, 23].…”

The Effectiveness of Acupuncture on Headache Intensity and Frequency in Patients With Tension-Type Headache: A Systematic Review and Meta-Analysis

“…Some compared acupuncture to sham while others with other techniques. Three studies utilized dry needling, and they were all evaluated as moderate methodological quality (Karakurum et al [ 19 ], Gildir et al [ 20 ], Kamali et al [ 21 ]). Moreover, three studies researched the effects of electroacupuncture, and all of them were evaluated as high quality (Xue et al [ 22 ], Chassot et al [ 23 ]), with one of them scoring 10/10 on the PEDro scale (Wang et al [ 24 ]).…”