Immediate Effects of Dry Needling and Myofascial Release on Local and Widespread Pressure Pain Threshold in Individuals With Active Upper Trapezius Trigger Points: A Randomized Clinical Trial

Fábio F Stieven; Giovanni E Ferreira; Francisco X de Araújo; Rodrigo F Angellos; Marcelo F Silva; Luis Henrique T da Rosa

doi:10.1016/j.jmpt.2020.07.003

Immediate Effects of Dry Needling and Myofascial Release on Local and Widespread Pressure Pain Threshold in Individuals With Active Upper Trapezius Trigger Points: A Randomized Clinical Trial

J Manipulative Physiol Ther. 2021 Feb;44(2):95-102. doi: 10.1016/j.jmpt.2020.07.003. Epub 2021 Jan 9.

Authors

Fábio F Stieven¹, Giovanni E Ferreira², Francisco X de Araújo³, Rodrigo F Angellos⁴, Marcelo F Silva⁵, Luis Henrique T da Rosa⁵

Affiliations

¹ Doctoral Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil; Feevale University, Health Science Institute, Novo Hamburgo, Brazil. Electronic address: fabiostieven@feevale.br.
² Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia.
³ Centro Universitário Ritter dos Reis / UniRitter, Porto Alegre, Brasil.
⁴ Private Practice, Porto Alegre, Brazil.
⁵ Doctoral Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.

PMID: 33431282
DOI: 10.1016/j.jmpt.2020.07.003

Abstract

Objective: This study sought to compare the immediate effects of a single session of dry needling (DN), myofascial release (MR), and sham DN on pressure pain threshold (PPT) and neck pain intensity in individuals with chronic neck pain.

Methods: This was a randomized trial with a blinded outcome assessor. Forty-four individuals with chronic neck pain and unilateral myofascial trigger points in the upper trapezius muscle (UTM) were randomized to receive DN (n = 15), MR (n = 14), or sham DN (n = 15). The PPT over the UTM (ipsilateral and contralateral sides) and the proximal head of the radius (ipsilateral and contralateral to the treated side) and neck pain were assessed immediately and 10 minutes after the intervention.

Results: There was no significant Group × Time interaction for PPT in the UTM on the treated side (F = 0.63, P = .641) or the contralateral side (F = 1.77, P = .144). However, there was a main effect of time on both the treated side (F = 4.917, P = .001) and the contralateral side (F = 4.70, P = .015), with DN and MR increasing PPT at the UTM. No significant Group × Time × Side interaction was found for PPT at the proximal head of the radius (F = 1.23, P = .276). Within-group analysis revealed a significant increase in PPT on the ipsilateral and contralateral sides in both DN and MR. Neck pain decreased after DN (P < .001), MR (P < .001), and sham DN (P = .008).

Conclusion: A single application of DN or MR generated local and distant hypalgesic responses superior to placebo. Future trials are needed to examine whether these findings occur in long-term follow-ups.

Keywords: Dry Needling; Musculoskeletal Manipulations; Trigger Points.

Publication types

Randomized Controlled Trial

MeSH terms

Adult
Chronic Pain / therapy
Dry Needling
Humans
Male
Manipulation, Osteopathic / statistics & numerical data*
Middle Aged
Myofascial Pain Syndromes / rehabilitation*
Neck Pain / rehabilitation*
Outcome Assessment, Health Care
Pain Threshold
Superficial Back Muscles / physiology*
Trigger Points / physiology*