Effects of Dry Needling on Muscle Stiffness in Latent Myofascial Trigger Points: A Randomized Controlled Trial

Sánchez-Infante, Jorge; Bravo-Sánchez, Alfredo; Jiménez, Fernando; Abián-Vicén, Javier

doi:10.1016/j.jpain.2021.02.004

Cited by 20 publications

(21 citation statements)

References 35 publications

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“…Three studies [ 34 , 36 , 45 ] assessed the effects of DN interventions on muscle stiffness, which is commonly involved in the MTrPs pathophysiology, obtaining positive results. Our findings are related to the conclusions recently reported by Sánchez-Infante et al [ 66 ] and Kelly et al [ 67 ]. The first stated that DN intervention in non-active MTrPS showed lower stiffness values after 24 h and 72 h follow-up compared to the sham-DN group and baseline.…”

Section: Discussionsupporting

confidence: 93%

Effectiveness of Dry Needling of Myofascial Trigger Points in the Triceps Surae Muscles: Systematic Review

et al. 2022

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This study aims to analyze the effects of Dry Needling (DN) for the release of myofascial trigger points (MTrPs) in the triceps surae muscles (TSM). A systematic review was performed up to February 2022 in PubMed, PEDro, Scopus, CENTRAL, and Web of Science. Selection criteria were studies involving subjects older than 18 years presenting MTrPs in the TSM, without any concomitant acute or chronic musculoskeletal conditions; DN interventions applied to the MTrPs of the TSM; and results on pain, range of motion (ROM), muscle strength, muscle stiffness, and functional outcomes. The PEDro scale was used to assess the methodological quality of the studies, and the Risk of Bias Tool 2.0 to assess risk of bias. A total of 12 studies were included in the systematic review, involving 426 participants. These results suggest that DN of MTrPs in TSM could have a positive impact on muscle stiffness and functional outcomes. There are inconclusive findings on musculoskeletal pain, ROM, and muscle strength. Significant results were obtained in favor of the control groups on pressure pain thresholds. Despite the benefits obtained on muscle stiffness and functional performance, the evidence for the use of DN of MTrPs in the TSM remains inconclusive.

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Section: Discussionsupporting

confidence: 93%

Effectiveness of Dry Needling of Myofascial Trigger Points in the Triceps Surae Muscles: Systematic Review

et al. 2022

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“…Although SWE is an objective alternative to manual palpation which showed to be a feasible tool for assessing the upper trapezius muscle intra-session stiffness [22], the main limitation found for this method is that its reliability showed to be moderate just if performed in rigorous conditions (e.g., reporting both shear wave speed and young modulus assessed in the longitudinal plane [31]. Therefore, those studies assessing transverse planes [32,33] or using operator-dependent elastography methods (e.g., strain elastography) should be interpreted carefully [11].…”

Section: Resultsmentioning

confidence: 99%

Is Shear-Wave Elastography a Clinical Severity Indicator of Myofascial Pain Syndrome? An Observational Study

Valera‐Calero

Sánchez-Jorge

Buffet-García

et al. 2021

JCM

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Since manual palpation is a subjective procedure for identifying and differentiate Myofascial Trigger Points -MTrPs-, the use of Shear Wave Elastography -SWE- as an objective alternative is increasing. This study aimed to analyze pain pressure thresholds -PPTs- and SWE differences between active MTrPs, latent MTrPs and control points located in the upper trapezius to analyze the association of SWE features with clinical severity indicators (e.g., pain extension area, PPTs, neck pain and neck disability). An observational study was conducted to calculate the correlation and to analyze the differences of sociodemographic, clinical and SWE features on 34 asymptomatic subjects with latent MTrPs and 19 patients with neck pain and active MTrPs. Significant PPT differences between active with latent MTrPs (p < 0.001) and control points (p < 0.001) were found, but no differences between latent MTrPs and control points (p > 0.05). No stiffness differences were found between active MTrPs with latent MTrPs or control points (p > 0.05). However, significant control point stiffness differences between-samples were found (p < 0.05). SWE showed no significant correlation with clinical severity indicators (p > 0.05). No stiffness differences between active and latent MTrPs were found. Neck pain patients showed increased control point stiffness compared with asymptomatic subjects. SWE showed no association with clinical severity indicators.

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“…Upon complete freeing of tension cells undergo apoptosis with reduction of α-SMA [94]. Studies indicate needling lowers myofascial stiffness as measured by shear wave elastography [95][96][97], suggesting a potential for a mechanical "re-alignment" of the fasciomusculoskeletal system and actual tensional release.…”

Section: Plos Onementioning

confidence: 99%

“…It was found that needling treatment reduces pain [243][244][245][246][247]. Studies suggest needling significantly lowers the shear modulus of myofascial tissue as measured by elastography (p-value <0.01) [95], causes mechanical changes at the point of insertion and at a distance [91,102], causes windup of the connective tissue [105], and improves perfusion to the area [248]. Meta-analyses and systematic reviews find that needling improves pain and stiffness in people with fibromyalgia and MPS [245,246,249].…”

Section: Plos Onementioning

confidence: 99%

Scoping review and interpretation of myofascial pain/fibromyalgia syndrome: An attempt to assemble a medical puzzle

Plaut

2022

PLoS ONE

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Background Myofascial Pain Syndrome (MPS) is a common, overlooked, and underdiagnosed condition and has significant burden. MPS is often dismissed by clinicians while patients remain in pain for years. MPS can evolve into fibromyalgia, however, effective treatments for both are lacking due to absence of a clear mechanism. Many studies focus on central sensitization. Therefore, the purpose of this scoping review is to systematically search cross-disciplinary empirical studies of MPS, focusing on mechanical aspects, and suggest an organic mechanism explaining how it might evolve into fibromyalgia. Hopefully, it will advance our understanding of this disease. Methods Systematically searched multiple phrases in MEDLINE, EMBASE, COCHRANE, PEDro, and medRxiv, majority with no time limit. Inclusion/exclusion based on title and abstract, then full text inspection. Additional literature added on relevant side topics. Review follows PRISMA-ScR guidelines. PROSPERO yet to adapt registration for scoping reviews. Findings 799 records included. Fascia can adapt to various states by reversibly changing biomechanical and physical properties. Trigger points, tension, and pain are a hallmark of MPS. Myofibroblasts play a role in sustained myofascial tension. Tension can propagate in fascia, possibly supporting a tensegrity framework. Movement and mechanical interventions treat and prevent MPS, while living sedentarily predisposes to MPS and recurrence. Conclusions MPS can be seen as a pathological state of imbalance in a natural process; manifesting from the inherent properties of the fascia, triggered by a disrupted biomechanical interplay. MPS might evolve into fibromyalgia through deranged myofibroblasts in connective tissue (“fascial armoring”). Movement is an underemployed requisite in modern lifestyle. Lifestyle is linked to pain and suffering. The mechanism of needling is suggested to be more mechanical than currently thought. A “global percutaneous needle fasciotomy” that respects tensegrity principles may treat MPS/fibromyalgia more effectively. “Functional-somatic syndromes” can be seen as one entity (myofibroblast-generated-tensegrity-tension), sharing a common rheuma-psycho-neurological mechanism.

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Effects of Dry Needling on Muscle Stiffness in Latent Myofascial Trigger Points: A Randomized Controlled Trial

Cited by 20 publications

References 35 publications

Effectiveness of Dry Needling of Myofascial Trigger Points in the Triceps Surae Muscles: Systematic Review

Effectiveness of Dry Needling of Myofascial Trigger Points in the Triceps Surae Muscles: Systematic Review

Is Shear-Wave Elastography a Clinical Severity Indicator of Myofascial Pain Syndrome? An Observational Study

Scoping review and interpretation of myofascial pain/fibromyalgia syndrome: An attempt to assemble a medical puzzle

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