Effects of Low-Load Exercise on Post-needling Induced Pain After Dry Needling of Active Trigger Point in Individuals with Subacromial Pain Syndrome.

PM R. 2017 May 05;:

Authors: Salom-Moreno J, Jiménez-Gómez L, Gómez-Ahufinger V, Palacios-Ceña M, Arias-Buría JL, Koppenhaver SL, Fernández-de-Las-Peñas C

Abstract
BACKGROUND: Application of dry needling is usually associated to post-needling induced-pain. Development of post-needling intervention targeting to reduce this adverse event is needed.
OBJECTIVE: To determine the effectiveness of low-load exercise on reducing post-needling induced-pain after dry needling of active trigger points (TrPs) in the infraspinatus muscle in subacromial pain syndrome.
DESIGN: A 72h follow-up, single-blind randomized controlled trial.
SETTING: Urban hospitals.
PARTICIPANTS: Individuals with subacromial pain syndrome (n=90, 52% female, mean age: 35±13 years) with active TrPs in the infraspinatus muscle.
INTERVENTIONS: All individuals received dry needling into infraspinatus active TrP. Then, they were randomly divided into experimental group, which received a single bout of low-load exercise of shoulder muscles; placebo group, which received inactive ultrasound for 10min; and control group, which did not receive any intervention.
OUTCOME MEASURES: Numerical pain rate scale (NPRS, 0-10 point) at post-needling, immediate post-intervention (2min), and 24h, 48h, and 72h after needling. Shoulder pain (NPRS, 0-10) and disability (DASH: Disabilities of the Arm, Shoulder and Hand; SPADI: Shoulder Pain and Disability Index) were assessed before and 72h after needling.
RESULTS: The 5×3 ANCOVA showed that the exercise group demonstrated a larger decrease in post-needling induced-pain immediately after (P=.001), 24h (P=.001) and 48h after (P=.006) than placebo or control groups. No differences were found at 72h (P=.03). Similar improvement in shoulder pain (P<.001) and related-disability (DASH: P<.001; SPADI: P<.001) was observed 72h after needling irrespective of the treatment group.
CONCLUSIONS: Low-load exercise was effective for reducing post-needling induced-pain on active TrPs in the infraspinatus muscle 24h and 48h after needling. The application of post-needling intervention did not influence short-term pain and disability changes.

PMID: 28483685 [PubMed – as supplied by publisher]