Therapeutic effects of dry needling in patients with upper trapezius myofascial trigger points

Maryam Abbaszadeh-Amirdehi, Noureddin Nakhostin Ansari, Soofia Naghdi, Gholamreza Olyaei, Mohammad Reza Nourbakhsh, Maryam Abbaszadeh-Amirdehi, Noureddin Nakhostin Ansari, Soofia Naghdi, Gholamreza Olyaei, Mohammad Reza Nourbakhsh

Abstract

Background: Active myofascial trigger points (MTrPs) are major pain generators in myofascial pain syndrome. Dry needling (DN) is an effective method for the treatment of MTrPs.

Objective: To assess the immediate neurophysiological and clinical effects of DN in patients with upper trapezius MTrPs.

Methods: This was a prospective, clinical trial study of 20 patients with upper trapezius MTrPs and 20 healthy volunteers (matched for height, weight, body mass index and age), all of whom received one session of DN. Primary outcome measures were neuromuscular junction response (NMJR) and sympathetic skin response (SSR). Secondary outcomes were pain intensity (PI) and pressure pain threshold (PPT). Data were collected at baseline and immediately post-intervention.

Results: At baseline, SSR amplitude was higher in patients versus healthy volunteers (p<0.003). With respect to NMJR, a clinically abnormal increment and normal reduction was observed in patients and healthy volunteers, respectively. Moreover, PPT of patients was less than healthy volunteers (p<0.0001). After DN, SSR amplitude decreased significantly in patients (p<0.01), but did not change in healthy volunteers. A clinically important reduction in the NMJR of patients and increment in healthy volunteers was demonstrated after DN. PPT increased after DN in patients, but decreased in healthy volunteers (p<0.0001). PI improved after DN in patients (p<0.001).

Conclusions: The results of this study showed that one session of DN targeting active MTrPs appears to reduce hyperactivity of the sympathetic nervous system and irritability of the motor endplate. DN seems effective at improving symptoms and deactivating active MTrPs, although further research is needed.

Trial registration number: IRCT20130316128.

Keywords: MYOFASCIAL PAIN; NEUROPHYSIOLOGY.

Conflict of interest statement

Competing interests: None declared.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Figures

Figure 1
Figure 1
Flow diagram of the study. DN, dry needling; NMJR, neuromuscular junction response; PPT, pressure pain thresholds; SSR, sympathetic skin response; TrP, trigger point.
Figure 2
Figure 2
(A) Positioning of participant for dry needling intervention. (B) Sympathetic skin response (SSR) of the median nerve. (C) Neuromuscular junction response (NMJR) of the accessory nerve.

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Source: PubMed

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