"Beneficial Effects of Dry Needling for Treatment of Chronic Myofascial Pain Persist for 6 Weeks After Treatment Completion".

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“Beneficial Effects of Dry Needling for Treatment of Chronic Myofascial Pain Persist for 6 Weeks After Treatment Completion”.

PM R. 2016 Jun 10;

Authors: Gerber LH, Sikdar S, Aredo JV, Armstrong K, Rosenberger WF, Shao H, Shah JP

Abstract
BACKGROUND: Dry needling is an effective treatment for reducing pain associated with active myofascial trigger points (aMTrPs) in the short term. The duration of the benefits of this treatment have not been fully assessed.
OBJECTIVE: This study attempts to determine whether the benefits of dry needling (DN) of a-MTrPs are sustained 6 weeks post-treatment.
DESIGN: Follow-up of a prospective study SETTING: University PARTICIPANTS: Forty-five subjects (13 males) with cervical pain > 3 months and a-MTrPs in the upper trapezius who completed 3 DN treatments, evaluated 6-weeks post-treatment.
INTERVENTIONS: None Main Outcome Measures: PRIMARY OUTCOMES: Changes from baseline to follow-up in scores for the verbal analogue scale (VAS), Brief Pain Inventory (BPI), and MTrP status. MTrPs were rated: active (spontaneously painful), latent (painful only on compression) and non-palpable nodule. Responders: patients whose MTrP status changed from active to latent or non-palpable nodule (resolved).
SECONDARY OUTCOMES: Pain pressure threshold (PPT), Profile of Mood States, Oswestry Disability Index (ODI), SF-36, Cervical Range of Motion.
RESULTS: Pain measures remained significantly improved 6 weeks post-treatment (p<.003), as did the SF-36 physical functioning score (.01) and ODI (p=.002). Side bending and PPT for subjects with unilateral MTrPs had sustained improvement (p=.002). The number of subjects with sustained MTrP response at 6 weeks was significant (p<.001). Comparing responders to non-responders, change in VAS and BPI were statistically significant (p = .006, p=.03), but PPT was not. Patients with higher baseline VAS have higher risk of not responding to DN, those with a greater drop in VAS from baseline have a higher probability of sustained response. One unit decrease in VAS at baseline results in a 6.3-fold increase in the odds of being a responder versus a non-responder (p = .008).
CONCLUSIONS: There is sustained reduction of pain scores after completion of DN, which is more likely with a greater drop in VAS. Patients with higher baseline VAS are less likely to respond to DN. Early intervention toward significant pain reduction is likely to be associated with sustained clinical response.

PMID: 27297448 [PubMed – as supplied by publisher]

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