Benefits of dry needling of myofascial trigger points on autonomic function and photoelectric plethysmography in patients with fibromyalgia syndrome

Abstract

Background: Fibromyalgia syndrome (FMS) is a condition characterised by the presence of chronic, widespread musculoskeletal pain, low pain threshold and hyperalgesia. Myofascial trigger points (MTrPs) may worsen symptoms in patients with FMS. Objective: The purpose of this randomised controlled trial was to compare the effects of dry needling and transcutaneous electrical nerve stimulation (TENS) on pain intensity, heart rate variability, galvanic response and oxygen saturation (SpO2). Methods: 74 subjects with FMS were recruited and randomly assigned to either the dry needling group or the TENS group. Outcomes measures (pain intensity, heart rate variability, galvanic skin response, SpO2 and photoplethysmography) were evaluated at baseline and after 6 weeks of treatment. 2×2 mixed-model analyses of variance (ANOVAs) were performed. Results: The mixed-model ANOVAs showed significant differences between groups for the sensory dimension of pain, affective dimension of pain, total dimension of pain, visual analogue scale (VAS) and present pain intensity (PPI) (P=0.001). ANOVAs also showed that significant differences between groups were achieved for very low frequency power of heart rate variability (P=0.008) and low frequency power (P=0.033). There were no significant differences in dry needling versus TENS groups on the spectral analysis of the photoplethysmography and SpO2. Conclusions: This trial showed that application of dry needling therapy and TENS reduced pain attributable to MTrPs in patients with FMS, with greater improvements reported in the dry needling group across all dimensions of pain. Additionally, there were between-intervention differences for several parameters of heart rate variability and galvanic skin responses. Trial registration number: NCT02393352

Efficacy of Dry Needling and Acupuncture in Patients with Fibromyalgia: A Systematic Review and Meta-Analysis

“…Eleven articles were excluded because they were not published in English or Spanish languages ( n = 8), were protocols ( n = 1) or had a case series design ( n = 2) or retrospective observational design ( n = 1). A total of twenty-four studies were included in this systematic review [ 6 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ]. The included articles investigated dry needling ( n = 4) or acupuncture ( n = 20), but none compared both techniques directly in the same study ( Figure 1 ).…”

“…Twenty studies investigated the effects of acupuncture in patients with FM ( Table 3 ). In the final qualitative analysis, four quasi-experimental studies [ 32 , 34 , 43 , 51 ], one experimental effectiveness comparative study [ 49 ] and sixteen controlled trials (of which fifteen were randomized [ 33 , 35 , 37 , 38 , 39 , 41 , 44 , 45 , 46 , 47 , 48 , 52 , 53 , 54 ], one non-randomized [ 40 ] and two double-blinded [ 38 , 41 ]) were included.…”

“…Most of the total participants ( n = 1497) were women ( n = 1481). Just two studies included a male sample ( n = 16) [ 38 , 51 ].…”

“…The acupuncture points most commonly treated were PC-6 (Neiguan), LI-4 (Hegu), GB-34 (Yanglingquan), SP-6 (Sanyinjiao), Du-14 (Da Zhui), Si- 3 (Houxi), Si-4 (Wangu), Si-15 (Jian Zhong Shu), Li-4 (He Gu), Li-11 (Qu Chi), H-7 (Shen Men), P-6 (Nei Guan), Ren-6 (Qihai), Liv-3 (Tai Chong), St-36 (Zu San Li), LR-3 (Taichong), UB-11 (Tianzhu), UB-12 (Fengmen), UB-13 (Feishu), UB-14 (Jueyinshu), GB-21 (Jianjing), UB-62 (Shenmai), UB-64 (Jinggu), UB-65 (Shugu) and Sp-6 (San Yin Jiao) [ 32 , 33 , 34 , 35 , 37 , 38 , 39 , 40 , 41 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 51 , 54 ].…”

Effect of dry needling on the variability of cardiac frequency in university members with temporomandibular dysfunction

“…Within the strategies used for pain and myofascial dysfunction, Dry Needling is one of the common treatment methods, which works by intramuscular insertion of a fine monofilament needle into the trigger point until a first, short and sudden local contraction response is got , suggested as a spinal cord reflex linked to the sensitivity of dysfunctional motor and Research, Society and Development, v. 10, n. 5, e49510515198, 2021 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v10i5.15198 end plates allowing the mechanical effect of the needle to disable the stitch and promote pain relief (Al-Moraissi et al, 2020;Castro-Sánchez et al, 2020;Fernández-de-Las-Peñas & Nijs, 2019). These trigger points are painful nodules in the intramuscular region that involves hyperalgesic areas with referred pain, a stretched band and can be classified as active, when they cause sensory symptoms and spontaneous pain, and as latent when pain is only referred to when stimulated (Baraja-Vegas et al, 2019;Dalewski et al, 2019;Fernández-de-las-Peñas & Dommerholt, 2018).…”