Evidence for Dry Needling in the Management of Myofascial Trigger Points Associated with Low Back Pain: A Systematic Review and Meta-analysis.

Arch Phys Med Rehabil. 2017 Jul 06;:

Authors: Liu L, Huang QM, Liu QG, Thitham N, Li LH, Ma YT, Zhao JM

Abstract
OBJECTIVE: To evaluate the current evidence of the effectiveness of dry needling of myofascial trigger points (MTrPs) associated with low back pain (LBP).
DATA SOURCES: PubMed, Ovid, EBSCO, ScienceDirect, Web of Science, Cochrane Library, Cumulative Index to Nursing and Allied Health, and China National Knowledge Infrastructure databases were searched until January 2017.
STUDY SELECTION: Randomized controlled trials (RCTs) that used dry needling as the main treatment and included participants diagnosed with LBP with the presence of MTrPs were included.
DATA EXTRACTION: Two reviewers independently screened articles, scored methodological quality, and extracted data. The primary outcomes were pain intensity and functional disability at post-intervention and follow-up.
DATA SYNTHESIS: A total of 11 RCTs involving 802 patients were included in the meta-analysis. Results suggested that compared with other treatments, dry needling of MTrPs was more effective in alleviating the intensity of LBP (Standardized Mean Difference [SMD] = -1.06, 95% Confidence Interval [CI]: -1.77 to -0.36, P = 0.003) and functional disability (SMD = -0.76, 95% CI: -1.46 to -0.06, P = 0.03); however, the significant effects of dry needling plus other treatments on pain intensity could be superior to dry needling alone for LBP at post-intervention (SMD = 0.83, 95% CI: 0.55 to 1.11, P < 0.00001).
CONCLUSIONS: Moderate evidence showed that dry needling of MTrPs, especially if associated with other therapies, could be recommended to relieve the intensity of LBP at post-intervention; however, the clinical superiority of dry needling in improving functional disability and its follow-up effects still remain unclear.

PMID: 28690077 [PubMed – as supplied by publisher]