Complement Ther Med. 2025 Dec 10:103314. doi: 10.1016/j.ctim.2025.103314. Online ahead of print.

ABSTRACT

BACKGROUN: Dry needling is frequently used for managing myofascial pain, yet the influence of needle manipulation technique on physiological responses remains uncertain.

OBJECTIVE: To compare the short-term effects of classical dynamic (pistoning) dry needling (CDN), static dry needling (SDN), and sham needling (shamN) on mechanical and microcirculatory properties of the upper trapezius muscle.

METHODS: In this randomized, single-blind, sham-controlled trial, 45 participants with upper-trapezius myofascial trigger points were allocated to CDN (n = 15), SDN (n = 15), or shamN (n = 15). CDN involved multiple fast in-out needle insertions to elicit local twitch responses, SDN consisted of a single needle insertion retained for 60seconds without manipulation, and shamN simulated insertion without skin penetration. Outcomes included pressure pain threshold (PPT, N/m²), muscle stiffness (N/m), tone (Hz), elasticity (D), and perfusion (PU), recorded at baseline, immediately, 60minutes, 24hours, and 7 days post-intervention. Data were analyzed with mixed (Group × Time) ANCOVA models using baseline as covariate.

RESULTS: A significant main effect of time was observed for PPT (p = 0.039, η²ₚ = 0.071) and a significant Time × Group interaction for elasticity (p < 0.001, η²ₚ = 0.974) and perfusion (p < 0.001, η²ₚ = 0.483). Post hoc comparisons showed higher PPT and perfusion and lower stiffness and tone in CDN compared with SDN and shamN across most time points (p < 0.05). No significant differences were found between SDN and shamN.

CONCLUSIONS: CDN induced greater short-term improvements in mechanical and perfusion outcomes of the upper trapezius than static or sham procedures, suggesting that needle manipulation intensity modulates physiological responses. Long-term studies are warranted to confirm sustained clinical relevance.

TRIAL REGISTRATION: ISRCTN16484644.

PMID:41386496 | DOI:10.1016/j.ctim.2025.103314