by Logan Swisher SPT
Background:
Myofascial pain syndrome is caused by myofascial trigger points or highly localized and irritable spots in muscle. Recently dry needling has been used as an instrument assisted technique to address myofascial trigger points. Research in the effectiveness of dry needling has been limited by the difficulty of providing a true control or sham treatment. This study took advantage of a planned total knee replacement to allow for needling vs no needling while a patient was under anesthesia to allow for a true randomized clinical trial. Trigger points are common in lower extremity muscles in patients with hip and/or knee osteoarthritis. Most patients experience the greatest amount of pain in the first month following a total knee replacement.
Participants:
40 total participants
-20 participants in the true dry needling group
-20 participants in the sham dry needling group
Methods:
This study was a double-blind, placebo-controlled, randomized clinical trial. Several hours prior to their total knee replacement surgery, patients were examined by experienced physical therapist for the presence of trigger points. The participants placed into the dry needling group received dry needling for 20 insertions of the intended site while under anesthesia. The participants in the sham dry needling* group did not receive any treatment for their trigger points. Patients gave a baseline and follow up measurements at 1, 3- and 6-months following surgery using the visual analog scale (VAS), need for postoperative analgesics, and the western Ontario and McMaster Universities Osteoarthritis Index Questionnaire (WOMAC).
Results:
There was a significant improvement in VAS values with the dry needling* group in the first month as compared to the sham dry needling* group. It was also found that the use of analgesic medications was significantly lower in the dry needling* group.
Dry Needling – Clinical Application:
This study demonstrated dry needling* of trigger points in the lower limbs allowed patients to reach the same degree of pain reduction in 1-month as the subjects with the placebo intervention achieved in 6-months. The use of dry needling* also significantly reduced the need for post surgical analgesic medications which is always a postoperative goal. While this study was limited to surgical patients, ti was a well-designed study which suggests dry needling* would be beneficial for many patients with muscle pain. Here at PTFirst we can incorporate the use of dry needling, other manual techniques and modalities to reduce muscle pain associated with surgery, injury, and/or overuse.
Dry Needling Article:
Mayoral, O., Salvat, I., Martín, M. T., Martín, S., Santiago, J., Cotarelo, J., & Rodríguez, C. (2013). Efficacy of myofascial trigger point dry needling* in the prevention of pain after total knee arthroplasty: A randomized, double-blinded, placebo-controlled trial. Evidence-Based Complementary and Alternative Medicine : ECAM, 2013, 694941-8. doi:10.1155/2013/694941