The neurophysiological effects of dry needling in patients with upper trapezius myofascial trigger points: study protocol of a controlled clinical trial

Abstract

IntroductionDry needling (DN) is an effective method for the treatment of myofascial trigger points (MTrPs). There is no report on the neurophysiological effects of DN in patients with MTrPs. The aim of the present study will be to assess the immediate neurophysiological efficacy of deep DN in patients with upper trapezius MTrPs.Methods and analysisA prospective, controlled clinical trial was designed to include patients with upper trapezius MTrPs and volunteered healthy participants to receive one session of DN. The primary outcome measures are neuromuscular junction response and sympathetic skin response. The secondary outcomes are pain intensity and pressure pain threshold. Data will be collected at baseline and immediately after intervention.Ethics and disseminationThis study protocol has been approved by the Research Council, School of Rehabilitation and the Ethics Committee of Tehran University of Medical Sciences. The results of the study will be disseminated in a peer-reviewed journal and presented at international congresses.

Effects of Temperature on Chronic Trapezius Myofascial Pain Syndrome during Dry Needling Therapy

“…After sterilization with disinfectant and draping were completed, the doctor wore sterile gloves to identify the MTrP using the left hand and intradermally injected 0.25% lidocaine at each point. When a local hillock in diameter of about 0.8 mm was formed, the needle in the right hand was injected vertically into the skin to reach the MTrP (the correct position was assumed as long as the usual symptoms of pain or local twitch response were observed [ 11 ]). The treatment above was performed on each MTrP for 15 min.…”

Evaluation of the Sympathetic Skin Response to the Dry Needling Treatment in Female Myofascial Pain Syndrome Patients

“…As SSR is strongly influenced by the autonomic nervous system, it could be used for active TP evaluation and treatment, as well as for peripheral neuropathy treatment accompanying autonomic nervous system disorders. Additionally, SSR may also be utilized in the diagnosis of reflex sympathetic dystrophy [ 2 , 22 ]. In 50% of multiple sclerosis cases, SSR abnormalities were detected, possibly due to lesions presented in the central sympathetic way.…”

“…Myofascial pain syndrome (MPS) can be defined as both a sensory-motor and an autonomic symptom complex [ 1 ]. Myofascial trigger points (MTrPs) are a common component of MPS in 30% of individuals, characterized by palpable taut bands within skeletal muscle fibers [ 2 ]: local hypersensitive points. Although this is known to be common in individuals with musculoskeletal dysfunction, they often go undiagnosed which may lead to chronic conditions [ 3 ].…”

“…The etiology of trigger point (TP) formation in muscle and its mechanism of producing somatic symptoms is not fully understood. However, peripheral mechanisms, such as biochemical changes in neuromuscular junctions due to overuse injuries, stand as a common explanation for this formation [ 2 , 4 ]. Conversely, it has become clear that a majority of chronic musculoskeletal pain cases are characterized by alterations in central nervous system processes and autonomic nervous system activation [ 2 , 5 ].…”

“…In regards to the utilization of different mechanisms, a variety of treatment methods are available: modified proprioceptive neuromuscular facilitation stretching [ 10 ], manual compression [ 11 , 12 ], tricyclic antidepressants [ 13 , 14 ], topical and injectable form of thiocolchicoside [ 15 , 16 ], tizanidine [ 17 ], botulinum toxin injection of lidocaine [ 9 , 16 , 18 ], TENS [ 18 ], US with therapeutic intensity [ 4 ], cold spray and stretch [ 1 , 19 ], ischemic compression [ 11 ], and superficial dry needling (DN) [ 16 , 19-21 ]. DN stands as a popular, yet, invasive method employed for the treatment of MTrPs [ 2 , 16 ]. Following thorough investigation, it is evident that only a single study focusing on the effects of DN on neuromuscular junction response (NMRJ) and autonomic responses in a population with MTrPs exists; however, no results were presented in this study.…”