by Logan Swisher, PT, DPT, OCS
Introduction
Fibromyalgia syndrome is characterized by chronic and diffuse musculoskeletal pain. The exact cause of fibromyalgia is unknown but abnormalities of the pain processing in the nervous system, such as hyper-responsiveness and hyper-excitability, may explain the chronic pain. Myofascial trigger point pain is defined as pain from one or more hyperirritable or hypersensitive palpable nodules in skeletal muscle which can refer pain locally and globally over the body. Myofascial release is a therapeutic intervention aimed at providing pain relief by restoring impaired soft tissue function. Dry needling, on the other hand, is a minimally invasive technique where an acupuncture needle is inserted directly into myofascial trigger points with the end goal of decreasing local and referred pain. This article aimed to compare the effectiveness of dry needling vs. myofascial release for patient with fibromyalgia.
Participants
64 total participants (58 women and 6 men)
-32 participants assigned to the dry needling group
-32 participants in the myofascial release group
Methods
In this single-blind randomized controlled trial patients were assigned to a dry needling or myofascial release group. Pain pressure thresholds of trigger points in the cervical muscles were assessed as well as quality of life, impact of fibromyalgia symptoms, quality of sleep, intensity of pain, anxiety and depression symptoms, and impact of fatigue at baseline and 4 weeks post treatment.
Results
Significant improvement was found in most pain pressure thresholds of the myofascial trigger points in cervical muscles in the dry needling group as compared to the myofascial release group. Dry needling also demonstrated higher improvements in quality of life, quality of sleep, anxiety, depression, fatigue and intensity of pain, whereas, myofascial release demonstrated significant improvement in intensity of pain and impact of fibromyalgia symptoms.
Clinical Relevance
When appropriate, dry needling therapy should be strongly considered with myofascial release techniques for patients with fibromyalgia. Here at Physical Therapy First, we have therapists trained in dry needling and myofascial release techniques. We will complete a thorough evaluation and comprise a multimodal treatment plan to address your current functional limitations and pain levels to help you restore your previous level of activity.
Reference
Castro Sánchez AM, García López H, Fernández Sánchez M, Pérez Mármol JM, Aguilar-Ferrándiz ME, Luque Suárez A, Matarán Peñarrocha GA. Improvement in clinical outcomes after dry needling versus myofascial release on pain pressure thresholds, quality of life, fatigue, pain intensity, quality of sleep, anxiety, and depression in patients with fibromyalgia syndrome. Disabil Rehabil. 2019 Sep;41(19):2235-2246. doi: 10.1080/09638288.2018.1461259. Epub 2018 Apr 23. PMID: 29681188.