The effect of dry needling on the active trigger point of upper trapezius muscle: Eliciting local twitch response on long-term clinical outcomes

Hakim, Iman Kamali; Takamjani, Ismail Ebrahimi; Sarrafzadeh, Javad; Ezzati, Kamran; Bagheri, Rasool

doi:10.3233/bmr-181286

Cited by 21 publications

(23 citation statements)

References 26 publications

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“…Presumably, the most common dry needling approach was suggested by Hong and it concerns the “fast in, fast out” method that requires obtaining the local twitch response (LTR) to confirm the proper placement of the needle penetrating the MTP [ 55 ]. However, recent studies by Hakim et al as well as the review by Perreault et al suggest that eliciting LTR is not necessary for successfully managing myofascial pain [ 56 , 57 ]. Moreover, Hakim et al implied the superiority of a few sessions of dry needling without obtaining LTR in long-term clinical observation, presumably due to the fact that repeated sessions of dry needling may cause increased connective tissues’ damage and impair the reinnervation process, which is a greater concern when applied to more aggressive methods requiring obtaining LTR [ 56 ].…”

Section: Discussionmentioning

confidence: 99%

Intramuscular Injections and Dry Needling within Masticatory Muscles in Management of Myofascial Pain. Systematic Review of Clinical Trials

Nowak

Chęciński²,

Nitecka-Buchta

et al. 2021

IJERPH

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(1) Background: Myofascial pain is an important cause of disability among the whole population, and it is a common symptom of temporomandibular joint disorders (TMDs). Its management techniques vary widely; however, in recent years, there has been a growing interest especially in needling therapies within masticatory muscles, due to their simplicity and effectiveness in pain reduction. (2) Methods: The construction of the following study is based on PICOS and PRISMA protocols. A systematic literature search was conducted based on the PubMed and BASE search engines. Searching the abovementioned databases yielded a total of 367 articles. The screening procedure and analysis of full texts resulted in the inclusion of 28 articles for detailed analysis. (3) Results: According to analyzed data, clinicians manage myofascial pain either with wet or dry needling therapies. The most thoroughly studied approach that prevails significantly within the clinical trials is injecting the botulinum toxin into the masseter and temporalis. Other common methods are the application of local anesthetics or dry needling; however, we notice the introduction of entirely new substances, such as platelet-rich plasma or collagen. In the analyzed articles, the target muscles for the needling therapies are most commonly localized by manual palpation although there are a variety of navigational support systems described: EMG, MRI or EIP electrotherapy equipment, which often aid the access to located deeper lateral and medial pterygoid muscle. (4) Conclusions: Needling therapies within masticatory muscles provide satisfactory effects while being simple, safe and accessible procedures although there still is a need for high quality clinical trials investigating especially injections of non-Botox substances and needling within lateral and medial pterygoid muscles.

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Section: Discussionmentioning

confidence: 99%

Intramuscular Injections and Dry Needling within Masticatory Muscles in Management of Myofascial Pain. Systematic Review of Clinical Trials

Nowak

Chęciński²,

Nitecka-Buchta

et al. 2021

IJERPH

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“…ere are studies showing that there is a decrease in pain without evident LTR after treating with DN (see, for example, Hakim et al [13]). Moreover, according to Perrault et al [10], LTR during DN seems unnecessary to control myofascial pain and is not related to many of the positive effects of DN.…”

Section: Discussionmentioning

confidence: 99%

“…ere are studies that obtain clinical benefits without the existence of LTR. For example, Hakim et al [13] working with patients with active MTrP in the upper trapezius muscle obtained that the DN without causing LTR has superiority over the DN along with causing LTR in clinical parameters that include pain, pressure threshold, and the range of lateral flexion movement of the neck. If the LTR occurs, the contraction induced in the area of the MTrP could help to clear nociceptive substances associated with GAGs reduction of pain.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Application of Galvanic Current in Rodents Reverses Signs of Myofascial Trigger Points

Margalef

Bosque

Monclús

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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An increase in the spontaneous release of acetylcholine (ACh) at the motor endplate is directly related to the generation of myofascial trigger points (MTrPs). In this study, percutaneous electric fields were applied to an animal model of MTrPs with high levels of spontaneous ACh release. All experiments were performed on Swiss mice and Sprague Dawley rats. For evaluating the spontaneous neurotransmission, intracellular recordings were performed, and the frequency of miniature endplate potentials was evaluated. Electromyographic recordings were also conducted to evaluate the endplate noise. Finally, the number and strength of local twitch responses (LTR) were evaluated using ultrasound recordings. The protocols used for the electric currents were 0.4 mA for five seconds and four repetitions (protocol 1), 1.5 mA for five seconds and three repetitions (protocol 2), and 3 mA for three seconds and three repetitions (protocol 3). After a subcutaneous injection of neostigmine (NTG), a great increase was observed in the frequency of mEPPs, together with an elevated endplate noise. Protocols 2 and 3 were the most effective. Protocol 3 could completely reverse the action of NTG at both three hours and 24 hours, respectively. The application of percutaneous currents produced both an increase in the number (144%) and in the speed (230% faster) of LTR compared with dry needling. In conclusion, higher doses of electrical current are more effective for decreasing MTrPs findings in an animal model.

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“…Several therapeutic approaches are implemented to treat MPS. Deep Dry Needling (DN) has recently attracted the attention of medical researchers [8]. DN is a frequent therapeutic technique, in which a solid, filiform, and stainless steel needle is inserted through the skin [7].…”

Section: Introductionmentioning

confidence: 99%

“…LTR) of DN. Moreover, the evaluation of treatment outcomes is a major concern following DN [7][8][9][10][11]. In this regard, Baraja-Vegas et al indicated that DN may elicit intramuscular edema and alternations in the contractile properties of muscles [11].…”

Section: Introductionmentioning

confidence: 99%

The Effects of Ultrasound-guided Dry Needling on Patients With Myofascial Pain Syndrome

Takamjani

Ezzati

Khani

et al. 2020

IRJ

Self Cite

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Objectives: Dry Needling (DN) is a novel and effective intervention for patients with Myofascial Pain Syndrome (MPS). Some characteristics, such as needle penetration depth, needle insertion into the target muscle, and trigger points must be identified in this intervention. The Ultrasound (US)-guided DN is a technique that involves needle insertion at the site of injury and the simulation of tissue injury and inflammation under US guidance; it indicates the needle insertion site to ensure that it does not penetrate the adjacent tissues. The current study aimed to review previous studies regarding the effects of US-guided DN on MPS. Methods: A search was performed in PubMed, Scopus, Cochrane, Google Scholar, Springer, and Science Direct databases to retrieve studies published from 2010 to March 2020. We included investigations regarding the effects of US-guided DN on the treatment of MPS. The following keywords and MeSH terms were used in the search process: “ultrasound-guided, musculoskeletal ultrasonography, myofascial pain syndrome, trigger points, and dry needling.” Results: A total of 47 relevant articles were retrieved. However, based on the inclusion and exclusion criteria of the review, 11 articles were finally selected. All studies reported significant pain relief following the use of US-guided DN in patients with MPS. Discussion: Considering the precise visualization of the site of muscle involvement, precise needle insertion, and reduction of the risk of further injury in US-guided DN may be a useful approach for MPS management in short-term and long-term studies.

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The effect of dry needling on the active trigger point of upper trapezius muscle: Eliciting local twitch response on long-term clinical outcomes

Cited by 21 publications

References 26 publications

Intramuscular Injections and Dry Needling within Masticatory Muscles in Management of Myofascial Pain. Systematic Review of Clinical Trials

Intramuscular Injections and Dry Needling within Masticatory Muscles in Management of Myofascial Pain. Systematic Review of Clinical Trials

Percutaneous Application of Galvanic Current in Rodents Reverses Signs of Myofascial Trigger Points

The Effects of Ultrasound-guided Dry Needling on Patients With Myofascial Pain Syndrome

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