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Needling therapies in the management of myofascial trigger point pain: a systematic review

PainSci » bibliography » Cummings et al 2001
updated
Tags: muscle pain, injections, dry needling, muscle, pain problems, medicine, treatment

Four articles on PainSci cite Cummings 2001: 1. The Complete Guide to Trigger Points & Myofascial Pain2. The Complete Guide to Chronic Tension Headaches3. Review of The Trigger Point Therapy Workbook4. Complete Guide to Frozen Shoulder

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

OBJECTIVE: To establish whether there is evidence for or against the efficacy of needling as a treatment approach for myofascial trigger point pain.

DATA SOURCES: PubMed, Ovid MEDLINE, Ovid EMBASE, the Cochrane Library, AMED, and CISCOM databases, searched from inception to July 999.

STUDY SELECTION: Randomized, controlled trials in which some form of needling therapy was used to treat myofascial pain.

DATA EXTRACTION: Two reviewers independently extracted data concerning trial methods, quality, and outcomes.

DATA SYNTHESIS: Twenty-three papers were included. No trials were of sufficient quality or design to test the efficacy of any needling technique beyond placebo in the treatment of myofascial pain. Eight of the 10 trials comparing injection of different substances and all 7 higher quality trials found that the effect was independent of the injected substance. All 3 trials that compared dry needling with injection found no difference in effect.

CONCLUSIONS: Direct needling of myofascial trigger points appears to be an effective treatment, but the hypothesis that needling therapies have efficacy beyond placebo is neither supported nor refuted by the evidence from clinical trials. Any effect of these therapies is likely because of the needle or placebo rather than the injection of either saline or active drug. Controlled trials are needed to investigate whether needling has an effect beyond placebo on myofascial trigger point pain.

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