Skip to main content

The effect of dry needling in the treatment of myofascial pain syndrome: a randomized double-blinded placebo-controlled trial

Clinical Rheumatology volume 32, pages 309–315 (2013)Cite this article

Abstract

The objective of this study was to test the hypothesis that dry needling is more effective than sham dry needling in the treatment of myofascial pain syndrome (MPS). This was a prospective, double-blinded, randomized-controlled study conducted in an outpatient clinic. Thirty-nine subjects with established myofascial trigger points were randomized into two groups: study group (N = 22) and placebo group (N = 17). Dry needling was applied using acupuncture needles, and sham dry needling was applied in the placebo group. The treatment was composed of six sessions which were performed in 4 weeks; the first four sessions were performed twice a week (for 2 weeks) and the last two, once a week (for 2 weeks). The visual analog scale (VAS) and Short Form-36 (SF-36) were used. When compared with the initial values, VAS scores of the dry needling group following the first and sixth sessions were significantly lower (p = 0.000 and p < 0.000, respectively). When VAS scores were compared between the groups, the first assessment scores were found to be similar, but the second and third assessment scores were found to be significantly lower in the dry needling group (p = 0.034 and p < 0.001, respectively). When SF-36 scores of the groups were compared, both the physical and mental component scores were found to be significantly increased in the dry needling group, whereas only those of vitality scores were found to be increased significantly in the placebo (sham needling) group. The present study shows that the dry needling treatment is effective in relieving the pain and in improving the quality of life of patients with MPS.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Abbreviations

MPS:

Myofascial pain syndrome

RCTs:

Randomized clinical trials

VAS:

Visual analog scale

QoL:

Quality of life

References

  1. Simons DG, Travell JG, Simons PT (1999) Travell and Simons' myofascial pain and dysfunction: the trigger point manual. Williams & Wilkins, Baltimore, pp 11–93

    Google Scholar 

  2. Simons DG (2002) Understanding effective treatments of myofascial trigger points. J Bodywork Movement Therap 6:81–88

    Article  Google Scholar 

  3. Borg-Stein J, Simons DG (2002) Focused review: myofascial pain. Arch Phys Med Rehabil 83:40–49

    Article  Google Scholar 

  4. Skootsky SA, Jaeger B, Oye RK (1989) Prevalence of myofascial pain in general internal medicine practice. West J Med 151:157–160

    PubMed  CAS  Google Scholar 

  5. Lavelle ED, Lavelle W, Smith HS (2007) Myofascial trigger points. Med Clin N Am 91:229–239

    PubMed  Article  Google Scholar 

  6. Cummings TM, White AR (2001) Needling therapies in the management of myofascial trigger point pain: a systematic review. Arch Phys Med Rehabil 82:986–992

    PubMed  Article  CAS  Google Scholar 

  7. King JC, Goddard MJ (1994) Pain rehabilitation: chronic pain syndrome and myofascial pain syndrome. Arch Phys Med Rehabil 75:9–14

    Article  Google Scholar 

  8. Lewit K (1979) The needle effect in the relief of myofascial pain. Pain 6:83–90

    PubMed  Article  CAS  Google Scholar 

  9. Hong CZ (1994) Lidocaine injection versus dry needling to myofascial trigger point. The importance of the local twitch response. Am J Phys Med Rehabil 73:256–263

    PubMed  Article  CAS  Google Scholar 

  10. Barbagli P, Bollettin R, Ceccherelli F (2003) Acupuncture (dry needle) versus neural therapy (local anesthesia) in the treatment of benign back pain. Immediate and long-term results. Minerva Med 94:17–25

    PubMed  CAS  Google Scholar 

  11. Ga H, Choi JH, Park CH, Yoon HJ (2007) Acupuncture needling versus lidocaine injection of trigger points in myofascial pain syndrome in elderly patients—a randomised trial. Acupunct Med 25:130–136

    PubMed  Article  Google Scholar 

  12. Cline ME, Herman J, Shaw ER, Morton RD (1992) Standardization of the visual analogue scale. Nurs Res 41:378–380

    PubMed  Article  CAS  Google Scholar 

  13. Demirsoy C (1999) The MOS-SF 36 health survey: a validation study with a Turkish sample. Master tezi, Boğaziçi Üniversitesi, İstanbul

  14. Tough EA, White AR, Cummings TM, Richards SH, Campbell JL (2009) Acupuncture and dry needling in the management of myofascial trigger point pain: a systematic review and meta-analysis of randomised controlled trials. Eur J Pain 13:3–10

    PubMed  Article  Google Scholar 

  15. DiLeronzo L, Traballesi M, Morelli D, Pompa A, Brunelli S, Buzzi MG et al (2004) Hemiparatic shoulder pain syndrome treating with dry needling during early rehabilitation: a prospective, open-labed, randomized investigation. J Musculoskel Pain 12:25–34

    Article  Google Scholar 

  16. Chu J (1997) Does EMG (dry needling) reduce myofascial pain symptoms due to cervical nerve root irritation? Electromyogr Clin Neurophysiol 37:259–272

    PubMed  CAS  Google Scholar 

  17. Itoh K, Katsumi Y, Kitakoji H (2004) Trigger point acupuncture treatment of chronic low back pain in elderly patients—a blinded RCT. Acupunct Med 22:170–177

    PubMed  Article  Google Scholar 

  18. Huguenin L, Brukner PD, McCrory P, Smith P, Wajswelner H, Bennell K (2005) Effect of dry needling of gluteal muscles on straight leg raise: a randomised, placebo controlled, double blind trial. British Journal of Sports Medicine 39:84–90

    PubMed  Article  CAS  Google Scholar 

  19. Ilbuldu E, Cakmak A, Disci R, Aydin R (2004) Comparison of laser, dry needling, and placebo laser treatments in myofascial pain syndrome. Photomed Laser Surg 22:306–311

    PubMed  Article  Google Scholar 

  20. Itoh K, Katsumi Y, Hirota S, Kitakoji H (2006) Effects of trigger point acupuncture on chronic low back pain in elderly patients—a sham-controlled randomised trial. Acupunct Med 24:5–12

    PubMed  Article  Google Scholar 

  21. Itoh K, Katsumi Y, Hirota S, Kitakoji H (2007) Randomised trial of trigger point acupuncture compared with other acupuncture for treatment of chronic neck pain. Compl Ther Med 15:172–179

    Article  Google Scholar 

  22. Sterling M, Valentin S, Vicenzino B, Souvlis T, Connelly LB (2009) Dry needling and exercise for chronic whiplash—a randomised controlled trial. BMC Musculoskelet Disord 10:160

    PubMed  Article  Google Scholar 

  23. Goddard G, Karibe H, McNeill C, Villafuerte E (2002) Acupuncture and sham acupuncture reduce muscle pain in myofascial pain patients. Journal of Orofacial Pain 16:71–76

    PubMed  Google Scholar 

  24. Gunn CC (1996) The Gunn approach to the treatment of chronic pain; intramuscular stimulation for myofascial pain of radiculopathic origin. Churchill Livingston, New York, pp 11–37

    Google Scholar 

  25. Streitberger K, Kleinhenz J (1998) Introducing a placebo needle into acupuncture research. Lancet 352:364–365

    PubMed  Article  CAS  Google Scholar 

  26. Park J, White AR, Lee H, Ernst E (1999) Development of a new sham needle. Acupunct Med 17:110–112

    Article  Google Scholar 

  27. Ceccherelli F, Rigoni MT, Gagliardi G, Ruzzante L (2002) Comparison of superficial and deep acupuncture in the treatment of lumbar myofascial pain: a double-blind randomized controlled study. Clin J Pain 18:149–153

    PubMed  Article  Google Scholar 

  28. Kawakita K (1993) Polymodal receptor hypothesis on the peripheral mechanisms of acupuncture and moxibustion. Am J Acupunct 21:331–338

    Google Scholar 

  29. Hong CZ (1994) Persistence of local twitch response with loss of conduction to and from the spinal cord. Arch Phys Med Rehabil 75:12–16

    PubMed  CAS  Google Scholar 

  30. Chen JT, Chung KC, Hou CR, Kuan TS, Chen SM, Hong CZ (2001) Inhibitory effect of dry needling on the spontaneous electrical activity recorded from myofascial trigger spots of rabbit skeletal muscle. Am J Phys Med Rehabil 80:729–735

    PubMed  Article  CAS  Google Scholar 

Download references

Disclosures

None.

Author information

Affiliations

  1. Department of Physical Medicine and Rehabilitation, Gülhane Military Medical Academy, Haydarpaşa Training Hospital, İstanbul, Turkey

    Levent Tekin, Selim Akarsu, Oğuz Durmuş, Engin Çakar, Ümit Dinçer & Mehmet Zeki Kıralp

Authors
  1. Levent Tekin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Selim Akarsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Oğuz Durmuş
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Engin Çakar
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ümit Dinçer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mehmet Zeki Kıralp
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Levent Tekin.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Tekin, L., Akarsu, S., Durmuş, O. et al. The effect of dry needling in the treatment of myofascial pain syndrome: a randomized double-blinded placebo-controlled trial. Clin Rheumatol 32, 309–315 (2013). https://doi.org/10.1007/s10067-012-2112-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-012-2112-3

Keywords

  • Dry needling
  • Myofascial pain syndrome
  • Pain
  • Quality of life