Dry Needling versus Trigger Point Injection for Neck Pain Symptoms Associated with Myofascial Trigger Points: A Systematic Review and Meta-analysis.

Pain Medicine : the Official Journal of the American Academy of Pain Medicine
Marcos J Navarro-SantanaGustavo Plaza-Manzano

Abstract

To examine the effects of dry needling against trigger point (TrP) injections (wet needling) applied to TrPs associated with neck pain. Electronic databases were searched for randomized clinical trials where dry needling was compared to TrP injections (wet needling) applied to neck muscles and collected outcomes on pain or related-disability. Secondary outcomes consisted of pressure pain thresholds, cervical mobility, and psychological factors. The Cochrane risk of bias (RoB) tool, the Physiotherapy Evidence Database (PEDro) score, and GRADE approach were used. Six trials were included. TrP injection reduced pain intensity (MD -2.13, 95%CI -3.22 to -1.03) with a large effect size (SMD -1.46, 95%CI -2.27 to -0.65) as compared to dry needling. No differences between TrP injection and dry needling were found for pain-related disability (MD 0.9, 95%CI -3.09 to 4.89), pressure pain thresholds (MD 25.78kPa, 95%CI -6.43 to 57.99kPa), cervical lateral-flexion (MD 2.02° 95%CI -0.19° to 4.24°) or depression (SMD -0.22, 95%CI -0.85 to 0.41). The RoB was low, but the heterogenicity and imprecision of results downgraded the evidence level. Low evidence suggests a superior effect of TrP injection (wet needling) for decreasing pain of cervica...Continue Reading

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