Dry needling in the management of myofascial trigger points: A systematic review of randomized controlled trials

Espejo-Antúnez, Luís; Tejeda, Jaime Fernández-Huertas; Casaña, José; Rodríguez-Mansilla, Juan; De-la-Cruz-Torres, Blanca; Ribeiro, Fernando; Silva, Ana

doi:10.1016/j.ctim.2017.06.003

Cited by 101 publications

(76 citation statements)

References 40 publications

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“…The mechanisms of action of DN in PMS patients are not well established. The effectiveness of DN is mostly based on other conditions, such as the presence of myofascial pain syndrome or trigger points . Given that palpation and diagnosis of trigger points in deep muscles are impossible, we could not detect the presence of trigger points in the piriformis muscle with either palpation or ultrasound imaging.…”

Section: Discussionmentioning

confidence: 99%

“…The dynamic needling technique was performed by slowly moving the needle in and out of the piriformis muscle with the goal of eliciting a local twitch response (LTR), a quick contraction of the local muscle fibers in response to mechanical perturbation, detected by ultrasound visualization . In the present study, the DN technique was similar to that used by Dommerholt and was done under real‐time ultrasound guidance, as reported by Smith et al Based on two recent systematic reviews on the effectiveness of the DN technique, the DN group participants receive three sessions (with 48‐hour intervals in between) over 1 week …”

Section: Methodsmentioning

confidence: 99%

“…The effectiveness of DN is mostly based on other conditions, such as the presence of myofascial pain syndrome or trigger points. 13,14,16 Given that palpation and diagnosis of trigger points in deep muscles are impossible, we could not detect the presence of trigger points in the piriformis muscle with either palpation or ultrasound imaging. In addition, the place of needling in the recommended safest piriformis muscle point is important due to sciatic nerve variation and it is a limitation of the piriformis DN technique.…”

Section: Pain Intensitymentioning

confidence: 99%

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Ultrasound‐guided dry needling decreases pain in patients with piriformis syndrome

et al. 2019

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Introduction Piriformis muscle syndrome (PMS) is a disorder that can lead to symptoms of buttock pain and limited hip‐joint mobility, and may have an impact on quality of life. Methods Thirty‐two patients with PMS were randomized to the treatment group, which included three sessions of ultrasound‐guided dry needling (DN) of the piriformis muscle (n = 16), or a waitlist control group (n = 16). The primary outcome was pain intensity measured on the visual analog scale recorded at baseline and then at 72 hours and 1 week after treatment. Results At 1‐week follow‐up, pain intensity was significantly less in the DN group than in the waitlist control group (−2.16 [−1.01 to −3.32], P = .007) by an amount consistent with clinically meaningful improvement. Discussion The findings suggest that DN resulted in clinically meaningful short‐term improvement in pain intensity of patients with PMS.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Pain Intensitymentioning

confidence: 99%

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Ultrasound‐guided dry needling decreases pain in patients with piriformis syndrome

et al. 2019

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“…In three of the five patients, the pain relief was immediate, and in all patients the vocal fold motion normalized. The authors equated the observed pain relief from LEMG to dry needling in the treatment of myofascial pain syndrome (MPS) . Dry needling at trigger points is thought to work through a hyperstimulatory analgesic effect.…”

Section: Discussionmentioning

confidence: 99%

“…The authors equated the observed pain relief from LEMG to dry needling in the treatment of myofascial pain syndrome (MPS). [7][8][9] Dry needling at trigger points is thought to work through a hyperstimulatory analgesic effect. Jung et al 6 suggested that pain can limit the range of vocal fold motion due to guarding, with hypomobility exacerbating the dysphonia.…”

Section: Primary Odynophoniamentioning

confidence: 99%

Primary odynophonia: When pain is out of proportion to dysphonia

et al. 2019

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Objectives/Hypothesis Odynophonia is generally regarded as a symptom of a voice disorder. However, a subset of patients with odynophonia have debilitating pain out of proportion to the relatively mild degree of dysphonia and are not responsive to voice therapy. The goals of this study were to 1) describe the symptomatology of this subset of patients and differentiate it from typical odynophonia, 2) propose alternate models to explain this phenomenon of primary odynophonia, and 3) present a new treatment paradigm based on the proposed models. Study Design Case series. Methods Inclusion criteria were complaint of persistent pain associated with voicing, normal vocal fold mobility, complete glottic closure, and limited or lack of response of pain to voice therapy. Presenting symptoms, voice evaluation, and treatment outcomes were reviewed. Results Eleven patients fit the inclusion criteria. The degree of pain did not follow the trajectory of vocal improvement with therapy. The pain was stagnant or worsened with voice exercises. The most dramatic improvement came about in one patient who received false vocal fold Botox injections, and another who received thyrohyoid lidocaine/triamcinolone injection. We propose that these patients had developed primary odynophonia, in which the pain had become self‐sustaining and no longer responded to correction of hyperfunctional vocal behavior. The mechanism of pain persistence may involve superior laryngeal neuralgia, cartilaginous or ligamentous inflammation, and/or central sensitization. Conclusions A minority of patients have primary odynophonia distinct from typical odynophonia. Direct treatment of pain may be advisable prior to or in conjunction with voice therapy. Level of Evidence 4 Laryngoscope, 130:E183–E189, 2020

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The Myofascial Examination

Wall

2020

Canine Lameness

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Dry needling in the management of myofascial trigger points: A systematic review of randomized controlled trials

Cited by 101 publications

References 40 publications

Ultrasound‐guided dry needling decreases pain in patients with piriformis syndrome

Ultrasound‐guided dry needling decreases pain in patients with piriformis syndrome

Primary odynophonia: When pain is out of proportion to dysphonia

The Myofascial Examination

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