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Effectiveness of dry needling for myofascial trigger points associated with neck and shoulder pain: a systematic review and meta-analysis

PainSci » bibliography » Liu et al 2015
Tags: dry needling, muscle pain, muscle, pain problems, treatment

Four articles on PainSci cite Liu 2015: 1. The Complete Guide to Trigger Points & Myofascial Pain2. The Complete Guide to Chronic Tension Headaches3. The Complete Guide to Neck Pain & Cricks4. Complete Guide to Frozen Shoulder

PainSci commentary on Liu 2015: ?This page is one of thousands in the bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

A meta-analysis of dry needling studies concluding that it “can be recommended” for the neck and shoulders for short and medium term pain relief, but “wet needling is found to be more effective.” Although drawing on data from 20 studies, I’m not sure how much to trust the findings of a Chinese review on any kind of needling, because China is notoriously an unreliable source when it comes to studying acupuncture (Vickers found that China basically doesn’t publish negative results about acupuncture).

~ Paul Ingraham

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 evaluate current evidence of the effectiveness of dry needling of myofascial trigger points (MTrPs) associated with neck and shoulder pain.

DATA SOURCES: PubMed, EBSCO, Physiotherapy Evidence Database, ScienceDirect, The Cochrane Library, ClinicalKey, Wanfang Data Chinese database, China Knowledge Resource Integrated Database, Chinese Chongqing VIP Information, «Including Chinese trials may be problematic.» and SpringerLink databases were searched from database inception to January 2014.

STUDY SELECTION: Randomized controlled trials were performed to determine whether dry needling was used as the main treatment and whether pain intensity was included as an outcome. Participants were diagnosed with MTrPs associated with neck and shoulder pain.

DATA EXTRACTION: Two reviewers independently screened the articles, scored methodological quality, and extracted data. The results of the study of pain intensity were extracted in the form of mean and SD data. Twenty randomized controlled trials involving 839 patients were identified for meta-analysis.

DATA SYNTHESIS: Meta-analyses were performed using RevMan version 5.2 and Stata version 12.0. The results suggested that compared with control/sham, dry needling of MTrPs was effective in the short term (immediately to 3 days) (standardized mean difference [SMD]=-1.91; 95% confidence interval [CI], -3.10 to -.73; P=.002) and medium term (SMD=-1.07; 95% CI, -1.87 to -.27; P=.009); however, wet needling (including lidocaine) was superior to dry needling in relieving MTrP pain in the medium term (SMD=1.69; 95% CI, .40-2.98; P=.01). Other therapies (including physiotherapy) were more effective than dry needling in treating MTrP pain in the medium term (9-28d) (SMD=.62; 95% CI, .02-1.21; P=.04).

CONCLUSIONS: Dry needling can be recommended for relieving MTrP pain in neck and shoulders in the short and medium term, but wet needling is found to be more effective than dry needling in relieving MTrP pain in neck and shoulders in the medium term.

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