Rate and maintenance of improvement of myofascial pain with dry needling alone vs. dry needling with intramuscular electrical stimulation: a randomized controlled trial

ABSTRACT

Study design

Prospective, randomized

Objectives

To determine the difference in rate and maintenance of improvement of pain and disability for Dry Needling (DN) compared to Dry Needling with Intramuscular Electrical Stimulation (DN/IMES), in Myofascial Pain Syndrome (MPS).

Background

DN and neuromuscular electrical stimulation (NMES) have been shown to be efficacious in treating MPS. DN/IMES for MPS treatment has not been studied extensively, but initial results are promising.

Methods

Forty-five subjects were randomly assigned to the DN (n = 25) or DN/IMES (n = 20) group. Both groups received six consecutive weekly treatments and completed NDI and NPRS questionnaires (week 0, 3, 6, and 12).

Results

Both DN and DN/IMES groups showed significant improvement between weeks 0–6 on NDI (p = 0.008 and 0.00002, respectively) and NPRS scores (0 = 0.017 and p = 0.018, respectively). DN/IMES group showed significant within group changes on the NPRS between weeks 0–3 (p = 0.029). No changes were noted in the DN or DN/IMES groups between week 6–12 on NDI (p = 0.497 and p = 0.714, respectively) or NPRS (p = 0.801 and p = 0.164, respectively).

Conclusion

DN and DN/IMES demonstrated improvement and maintenance in disability and pain for 6 weeks. No differences in improvement of disability or pain existed between the groups at week 6 or 12.

Graphical abstract

KEYWORDS:

• Trigger point dry needling
• upper trapezius
• neck Pain
• shoulder pain

Key points

• Findings: Dry needling is an effective treatment for MPS. Both DN and DN/IMES are effective at intermediate term maintenance of improvements in neck pain and disability.

• Implications: Dry Needling treatment continues to demonstrate promise for the treatment of MPS.

• Caution: This study was limited by the small sample size utilized and the ceiling effect observed with the outcome measures.

Acknowledgments

We would like to thank the Doctor of Physical Therapy Program at the University of Mary Hardin-Baylor for support with this project.

Data availability statement

The data that support the findings of this study are available on request from the corresponding author, KLB. The data are not publicly available due to their containing information that could compromise the privacy of research participants.

Disclosure statement

No potential conflict of interest was reported by the authors.

Geolocational information

University of Mary Hardin- Baylor Website: https://go.umhb.edu/graduate/physical-therapy/home

Contact Email: [email protected]

Additional information

Notes on contributors

Kindyle Brennan

Dr. Brennan is a professor in the Physical Therapy Program at the University of Mary Hardin-Baylor. She is a Board-Certified Orthopaedic Clinical Specialist, Certified Orthopaedic Manual Therapist, and certified in dry needling.

Katherine M. Elifritz

Dr. Elifritz is a staff physical therapist at Virginia Sports Medicine Institute and was a DPT student at the University of Mary Hardin-Baylor when she participated in this research.

Megan M. Comire

Dr. Comire is a staff physical therapist at Inspire Physical Therapy and was a DPT student at the University of Mary Hardin-Baylor when she participated in this research.

Daniel C. Jupiter

Dr. Jupiter is an Associate Professor in Preventive Medicine and Population Health, and in the Office of Biostatistics, at the University of Texas Medical Branch.