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

Lin Liu; Qiang-Min Huang; Qing-Guang Liu; Gang Ye; Cheng-Zhi Bo; Meng-Jin Chen; Ping Li

doi:10.1016/j.apmr.2014.12.015

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

Arch Phys Med Rehabil. 2015 May;96(5):944-55. doi: 10.1016/j.apmr.2014.12.015. Epub 2015 Jan 7.

Authors

Lin Liu¹, Qiang-Min Huang², Qing-Guang Liu¹, Gang Ye³, Cheng-Zhi Bo¹, Meng-Jin Chen¹, Ping Li⁴

Affiliations

¹ Department of Sport Medicine and the Center of Rehabilitation, School of Sport Science, Shanghai University of Sport, Shanghai, China.
² Department of Sport Medicine and the Center of Rehabilitation, School of Sport Science, Shanghai University of Sport, Shanghai, China; Department of Pain Rehabilitation, Shanghai Hudong Zhonghua Shipbuilding Group Staff-worker Hospital, Shanghai, China. Electronic address: huaqia404@aliyun.com.
³ Department of Pain Rehabilitation, Tongji Hospital, Tongji University, Shanghai, China.
⁴ Department of Pain Rehabilitation, Shanghai Hudong Zhonghua Shipbuilding Group Staff-worker Hospital, Shanghai, China.

PMID: 25576642
DOI: 10.1016/j.apmr.2014.12.015

Abstract

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, 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.

Keywords: Meta-analysis; Neck pain; Needles; Randomized controlled trial; Rehabilitation; Shoulder pain; Trigger points.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Female
Humans
Injections / methods*
Male
Neck Pain / rehabilitation*
Pain Measurement
Physical Therapy Modalities*
Randomized Controlled Trials as Topic
Range of Motion, Articular
Shoulder Pain / rehabilitation*
Superficial Back Muscles
Trigger Points*