Efficacy of Dry Needling Under EMG Guidance for Myofascial Neck and Shoulder Pain: A Randomized Clinical Trial

Qingguang Liu; Qiangmin Huang; Lin Liu; Thi-Tham Nguyen

doi:10.2147/JPR.S372074

Efficacy of Dry Needling Under EMG Guidance for Myofascial Neck and Shoulder Pain: A Randomized Clinical Trial

J Pain Res. 2022 Aug 8:15:2293-2302. doi: 10.2147/JPR.S372074. eCollection 2022.

Authors

Qingguang Liu¹, Qiangmin Huang^{2

3}, Lin Liu⁴, Thi-Tham Nguyen⁵

Affiliations

¹ International College of Football, Tongji University, Shanghai, People's Republic of China.
² Department of Sport Rehabilitation, School of Kinesiology, Shanghai University of Sport, Shanghai, People's Republic of China.
³ Shanghai Ciyuan Rehabilitation Hospital, Sinopharm Healthcare, Shanghai, People's Republic of China.
⁴ Department of Rehabilitation, School of Sport and Health, Nanjing Sport Institute, Nanjing, People's Republic of China.
⁵ Faculty of Sport Science, Ton Duc Thang University, Ho Chi Minh City, Vietnam.

Abstract

Purpose: To determine the difference in maintenance of improvement of pain and disability for dry needling (DN) under needle electromyography (EMG) guidance technique in myofascial neck and shoulder pain patients, compared with DN alone.

Patients and methods: In this randomized single-blind clinical trial, 30 participants with myofascial pain in the neck and shoulder were randomly allocated to two groups: myofascial trigger points (MTrPs) DN with EMG guided (DN-EMG) group and MTrPs DN without EMG (DN) group. Needling treatment lasted for 2 weeks, twice a week. The primary outcome was pain intensity as assessed by visual analogue scale (VAS) and neck disability index (NDI). A number of mappings referred to pain and spontaneous muscle activity (SEA) were considered secondary outcomes. VAS and NDI were measured before treatment, after 2 weeks of intervention and at 4-, 6- and 12-week follow-up periods after the intervention. Secondary outcomes were assessed before each treatment (T1-T4). Data were analysed using mixed-model analyses of variance (ANOVA) with time as a within-subject variable and groups as between-subject variables followed by Bonferroni's post-hoc test.

Results: Mixed-model ANOVA revealed significant time-by-group interaction effects (F = 3.49, P = 0.01) for VAS. Post-hoc analysis showed a significant decrease in VAS and NDI after 2 weeks of intervention and at all follow-up periods compared with baseline in both groups (p < 0.01). The DN-EMG group exhibited higher improvements in VAS at 6- and 12-week follow-up period than the DN group (p < 0.05). In the SEA of MTrPs, we found positive sharp waves, fibrillation and fascicular potentials. DN-EMG group exhibited lower amplitudes at T2-T4 and frequencies at T2 and T3.

Conclusion: DN under needle EMG guidance technique exhibited greater improvements in maintenance of improvement of pain and lower SEA value than the DN group due to sufficient MTrPs inactivation.

Keywords: muscle pain; myofascial trigger point; needling.

Grants and funding

The present study is supported by the Fundamental Research Funds for the Central Universities (grant number: 22120190126) and the National Natural Science Foundation of China (NSFC), (grant number: 81470105).