CORE Physical Therapy in Omaha Explains…Dry Needling
By Dr. Mark Rathjen PT DPT CSCS
CORE Physical Therapy Founder/owner/head clinician.
The 2 articles below, show the abstracts to dry needling studies relating to trigger points. The style of dry needling we perform here at CORE is call trigger point dry needling. Its the most aggressive and efficient form of dry needling, though in our experience the most effective.
NOTE, Trigger point dry needling is more invasive than traditional needling and/or acupuncture. It will likely take less time to perform, but more uncomfortable while its being implemented.
Study 1
“Very low-quality to moderate-quality evidence suggests that dry needling performed by physical therapists is more effective than no treatment, sham dry needling, and other treatments for reducing pain and improving pressure pain threshold in patients presenting with musculoskeletal pain in the immediate to 12-week follow-up period. Low-quality evidence suggests superior outcomes with dry needling for functional outcomes when compared to no treatment or sham needling.”
This reads just like it sounds. Its a game changer, but not a fix all. Dry needling allows for faster return to recovery, baseline and decreasing pain. It does not usually fix the inherent issue that is CAUSING the trigger or painful trigger that we are actually treating. It truly allows us to fix you faster and more efficiently.
Study 2
“The majority of high-quality studies included in this review show measured benefit from TDN for MTrPs in multiple body areas, suggesting broad applicability of TDN treatment for multiple muscle groups. Further high-quality research is warranted to standardise TDN methods to determine clinical applicability.”
Most of the patients with single and multiple trigger points showed broad use and benefit from trigger point needling. what is harder to determine is the skill of the practitioner, the type of trigger point needling they are trained in, or the type of traditional needling used in the study. I will only comment in the more invasive style of trigger point dry needling with the trench response and the pistoning of the needle during the intervention. This is the style we are using here at CORE in Omaha.
Trigger point needling is fast, and effective to get a muscle to relax and get the body to a baseline to re assess what the actual issue is that is causing the trigger point to develop in the first place. Is dry needling necessary to fix an issue, NO. Will it fix it faster and allow us to find the root of the issue faster, YES.
C.O.R.E. Physical Therapy and Sports Performance PC,
is
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Dr. Mark Rathjen and Dr. Claire Rathjen. CORE is a family owned business that has been
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CORE Physical Therapy and Sports Performance PC.
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Omaha, NE 68130
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Abstract https://www.jospt.org/doi/full/10.2519/jospt.2017.7096
Study Design
Systematic review and meta-analysis.
Background
An increasing number of physical therapists in the United States and throughout the world are using dry needling to treat musculoskeletal pain.
Objective
To examine the short- and long-term effectiveness of dry needling delivered by a physical therapist for any musculoskeletal pain condition.
Methods
Electronic databases were searched. Eligible randomized controlled trials included those with human subjects who had musculoskeletal conditions that were treated with dry needling performed by a physical therapist, compared with a control or other intervention. The overall quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation.
Results
The initial search returned 218 articles. After screening, 13 were included. Physiotherapy Evidence Database quality scale scores ranged from 4 to 9 (out of a maximum score of 10), with a median score of 7. Eight meta-analyses were performed. In the immediate to 12-week follow-up period, studies provided evidence that dry needling may decrease pain and increase pressure pain threshold when compared to control/sham or other treatment. At 6 to 12 months, dry needling was favored for decreasing pain, but the treatment effect was not statistically significant. Dry needling, when compared to control/sham treatment, provides a statistically significant effect on functional outcomes, but not when compared to other treatments.
Conclusion
Very low-quality to moderate-quality evidence suggests that dry needling performed by physical therapists is more effective than no treatment, sham dry needling, and other treatments for reducing pain and improving pressure pain threshold in patients presenting with musculoskeletal pain in the immediate to 12-week follow-up period. Low-quality evidence suggests superior outcomes with dry needling for functional outcomes when compared to no treatment or sham needling. However, no difference in functional outcomes exists when compared to other physical therapy treatments. Evidence of long-term benefit of dry needling is currently lacking.
Effectiveness of trigger point dry needling for multiple body regions: a systematic review
Background
Trigger point dry needling (TDN) is commonly used to treat musculoskeletal pain related to myofascial trigger points (MTrPs). To date, no systematic review of high-quality randomised controlled trials (RCTs) investigating TDN to multiple body regions exists.
Purpose
The aim of this review is to determine the effectiveness of TDN based on high-quality RCTs for all body regions.
Methods
To ensure thorough reporting, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed as the methodological basis for this systematic review. PubMed, Physiotherapy Evidence Database (PEDro), Cinahl, Cochrane and reference lists were searched for the years 2000–2014 and the terms ‘TDN’, ‘dry needling NOT trigger point’, ‘functional dry needling’ and ‘intramuscular manual therapy’. Inclusion criteria: RCTs with PEDro scores 6–10 investigating TDN. Exclusion criteria: duplicates, non-human participants, non-English language, exclusive focus on acupuncture or medicinal injections. Three investigators searched databases, applied criteria, read and assigned PEDro scores to every RCT. Nineteen studies met the criteria. As compared to either baseline or control groups, significant differences were found for pain (14 studies), range of motion (ROM) (five studies) and at least one item on function and quality of life measures (six studies).
Limitations
This review was limited by inclusion criteria, timeframe, language and databases searched.
Conclusion
The majority of high-quality studies included in this review show measured benefit from TDN for MTrPs in multiple body areas, suggesting broad applicability of TDN treatment for multiple muscle groups. Further high-quality research is warranted to standardise TDN methods to determine clinical applicability.