Needling: is there a point?

Dommerholt, Jan; Fernández‐de‐las‐Peñas, César; Petersen, Shannon

doi:10.1080/10669817.2019.1620049

Cited by 5 publications

(6 citation statements)

References 31 publications

(27 reference statements)

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“…This scoping review demonstrates that for SRD, DN was primarily applied to myofascial structures for myofascial pain or TrP diagnoses, although other non-myofascial and non-specific diagnoses were also treated. Dry needling treatment to non-myofascial sites has been investigated primarily in extremity conditions [99]. There is currently little research on DN that specifically targets other SRD pain generators [16] including nerve roots, disc, tendons, ligaments, periosteum, scar tissue or fascia in SRD.…”

Section: Discussionmentioning

confidence: 99%

Dry needling for spine related disorders: a scoping review

Funk

Frisina-Deyo

2020

Chiropr Man Therap

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Introduction/Background: The depth and breadth of research on dry needling (DN) has not been evaluated specifically for symptomatic spine related disorders (SRD) from myofascial trigger points (TrP), disc, nerve and articular structures not due to serious pathologies. Current literature appears to support DN for treatment of TrP. Goals of this review include identifying research published on DN treatment for SRD, sites of treatment and outcomes studied. Methods: A scoping review was conducted following Levac et al.'s five part methodological framework to determine the current state of the literature regarding DN for patients with SRD. Results: Initial and secondary search strategies yielded 55 studies in the cervical (C) region (71.43%) and 22 in the thoracolumbar-pelvic (TLP) region (28.57%). Most were randomized controlled trials (60% in C, 45.45% in TLP) and clinical trials (18.18% in C, 22.78% in TLP). The most commonly treated condition was TrP for both the C and TLP regions. In the C region, DN was provided to 23 different muscles, with the trapezius as treatment site in 41.88% of studies. DN was applied to 31 different structures in the TLP region. In the C region, there was one treatment session in 23 studies (41.82%) and 2-6 treatments in 25 (45.45%%). For the TLP region, one DN treatment was provided in 8 of the 22 total studies (36.36%) and 2-6 in 9 (40.9%). The majority of experimental designs had DN as the sole intervention. For both C and TLP regions, visual analogue scale, pressure pain threshold and range of motion were the most common outcomes. Conclusion: For SRD, DN was primarily applied to myofascial structures for pain or TrP diagnoses. Many outcomes were improved regardless of diagnosis or treatment parameters. Most studies applied just one treatment which may not reflect common clinical practice. Further research is warranted to determine optimal treatment duration and frequency. Most studies looked at DN as the sole intervention. It is unclear whether DN alone or in addition to other treatment procedures would provide superior outcomes. Functional outcome tools best suited to tracking the outcomes of DN for SRD should be explored.

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Section: Discussionmentioning

confidence: 99%

Dry needling for spine related disorders: a scoping review

Funk

Frisina-Deyo

2020

Chiropr Man Therap

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“…Dry needling is a treatment modality that is minimally invasive, cost-effective, easy to learn with appropriate training, and carries a low risk of complications [4]. Yet, the effectiveness of this novel treatment technique is still under discussion and results vary widely over the published literature [5].…”

Section: Introductionmentioning

confidence: 99%

“…The most common and best supported DN approach targets myofascial trigger points (MTrPs) and aims to induce peripheral and central physiological and clinical effects [5][6][7][8]. Among patients with acute and chronic MSK disorders, myofascial pain syndrome is often present and is described as one of the underlying causes of the dysfunction [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Clinical Effectiveness of Dry Needling in Patients with Musculoskeletal Pain—An Umbrella Review

Chys

Meulemeester

Greef

et al. 2023

JCM

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The number of systematic reviews (SR) summarizing the literature regarding the clinical effects of Dry Needling (DN) has increased rapidly. Yet, rigorous evidence about the clinical effectiveness of this technique is still lacking. The aim of this umbrella review is to summarize the evidence about the clinical effects of trigger point DN on musculoskeletal disorders across all body regions. PubMed, Web of Science and Embase were searched to identify SRs examining the effect of DN (as a stand-alone intervention or combined with another treatment modality) compared to sham/no intervention or a physical therapy (PT) intervention with at least one clinical outcome in the domain of pain or physical functioning. Risk of bias (RoB) was assessed with the AMSTAR-2 tool. Quantification of the overlap in primary studies was calculated using the corrected covered area (CCA). The electronic search yielded 2286 results, of which 36 SRs were included in this review. Overall, DN is superior to sham/no intervention and equally effective to other interventions for pain reduction at short-term regardless of the body region. Some SRs favored wet needling (WN) over DN for short-term pain reductions. Results on physical functioning outcomes were contradictory across body regions. Limited data is available for mid- and long-term effects. DN has a short-term analgesic effect in all body regions and may be of additional value to the interventions that are used to date in clinical practice. Several studies have shown an additional treatment effect when combining DN to physiotherapeutic interventions compared to these interventions in isolation. There is a substantial need for the standardization of DN protocols to address the problem of heterogeneity and to strengthen the current evidence.

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“…When noninvasive treatment options fail to improve patients' symptoms, 8 percutaneous and invasive treatments, like dry needling (DN), are often considered. DN is widely used in the clinic to alleviate pain and improve range of motion 9 . In DN, the injured tendon is repeatedly “peppered” with a small gauge needle, which is thought to disrupt the chronic degenerative process, introduce localized bleeding, and facilitate healing by stimulating the release of growth factors, including insulin growth factor 1 (IGF‐1), transforming growth factor beta (TGF‐β), and vascular endothelial growth factor A (VEGF‐A) 10–12 .…”

Section: Introductionmentioning

confidence: 99%

“…DN is widely used in the clinic to alleviate pain and improve range of motion. 9 In DN, the injured tendon is repeatedly "peppered" with a small gauge needle, which is thought to disrupt the chronic degenerative process, introduce localized bleeding, and facilitate healing by stimulating the release of growth factors, including insulin growth factor 1 (IGF-1), transforming growth factor beta (TGF-β), and vascular endothelial growth factor A (VEGF-A). [10][11][12] However, repeated needle insertions may negatively disrupt the collagen fibers, as collagen fiber (~1-300 μm) 13 and needle (514.4-1270 μm) 14 diameters are not similar in size.…”

Section: Introductionmentioning

confidence: 99%

Focused ultrasound as an alternative to dry needling for the treatment of tendinopathies: A murine model

Khandare,

Smallcomb,

Elliott

et al. 2023

Journal Orthopaedic Research

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Tendinopathies account for 30% of 102 million annual musculoskeletal injuries occurring annually in the United States. Current treatments, like dry needling, induce microdamage to promote healing but produce mixed success rates. Previously, we showed focused ultrasound can noninvasively create microdamage while preserving mechanical properties in ex vivo murine tendons. This present study compared growth factor, histological, and mechanical effects after focused ultrasound or dry needling treatments in an in vivo murine tendon injury model. Partial Achilles tenotomy was performed in 26 rats. One‐week postsurgery, tendons were treated with focused ultrasound (1.5 MHz, 1‐ms pulses at 10 Hz for 106 s, p+ = 49 MPa, p− = 19 MPa) or dry needling (30 G needle, 5 fenestrations over 20 s) and survived for 1 additional week. Blood was collected immediately before and after treatment and before euthanasia; plasma was assayed for growth factors. Treated tendons and contralateral controls were harvested for histology or mechanical testing. No differences were found between treatments in release of insulin growth factor 1 and transforming growth factor beta; vascular endothelial growth factor A concentrations were too low for detection. Histologically, focused ultrasound and dry needling tendons displayed localized fibroblast infiltration without collagen proliferation with no detectable differences between treatments. Mechanically, stiffness and percent relaxation of dry needling tendons were lower than controls (p = 0.0041, p = 0.0441, respectively), whereas stiffness and percent relaxation of focused ultrasound tendons were not different from controls. These results suggest focused ultrasound should be studied further to determine how this modality can be leveraged as a therapy for tendinopathies.

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Needling: is there a point?

Cited by 5 publications

References 31 publications

Dry needling for spine related disorders: a scoping review

Dry needling for spine related disorders: a scoping review

Clinical Effectiveness of Dry Needling in Patients with Musculoskeletal Pain—An Umbrella Review

Focused ultrasound as an alternative to dry needling for the treatment of tendinopathies: A murine model

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