Journal of Research in Rehabilitation Sciences

A Comparison of the Effects of Dry Needling and Postural Correction Education on Pain, Pain Threshold, and Functional Disability on the Active Upper Trapezius's Trigger Points: A Randomized Controlled Trial (Pilot Study)

Document Type : Original Articles

Authors

1 MSc Student, Student Research Committee (Treata), Department of Physiotherapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

2 Assistant Professor, Department of Physiotherapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

3 Associate Professor, Department of Physiotherapy, School of Allied Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 Instructor, Department of Physical Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

10.22122/jrrs.v12i4.2760

Abstract

Introduction: Myofascial trigger points in upper trapezius have been reported as a common symptom of patients with neck pain. The aim of this study was to compare the effects of dry needling and postural correction reeducation on pain, pain threshold, and functional disability in patient with upper trapezius trigger points.Materials and Methods: This pilot study was a single-blind, randomized clinical trial. The 15 participants were randomly assigned to 3 groups; the first group received dry needling and conventional physiotherapy, the second group received postural correction (PC) and conventional physiotherapy, and the third group (control) received only conventional physiotherapy. Interventional effects were examined in three aspects including pain pressure threshold, neck pain, and functional disability using an algometer, visual analogue scale (VAS), and the Neck Disability Index (NDI), respectively. Patients were evaluated at the three stages of before the treatment, immediately after the treatment, and 6 weeks after the last treatment session.Results: Despite the significant effects of the three treatment methods on increased pain threshold, and reduced severity of pain and functional disability (P < 0.05), the results showed no significant difference between the groups in the last session (P > 0.05). However, significant differences were observed between the two interventional groups ‎and the control group (P < 0.05) 6 weeks after the treatment. The statistical test power of VAS on the last session and 6 weeks after the treatment was, respectively, 68% and 79%.Conclusion: Due to the positive effects of dry needling and postural correction reeducation and the significant difference of these groups with the control group 6 weeks after the treatment, the use of these treatment methods is recommended in individuals with upper trapezius trigger points.

Keywords

  1. Tough EA, White AR, Cummings TM, Richards SH, Campbell JL. 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 2009; 13(1): 3-10.
  2. Nambi GS, Sharma R, Inbasekaran D, Vaghesiya A, Bhatt U. Difference in effect between ischemic compression and muscle energy technique on upper trepezius myofascial trigger points: Comparative study. Int J Health Allied Sci 2013; 2(1): 17-22.
  3. Chaitow L. Muscle energy techniques. 3rd ed. Philadelphia, PA: Churchill Livingstone; 2006.
  4. Fernandez-de-las-Penas C, Alonso-Blanco C, Miangolarra JC. Myofascial trigger points in subjects presenting with mechanical neck pain: a blinded, controlled study. Man Ther 2007; 12(1): 29-33.
  5. Rudin NJ. Evaluation of treatments for myofascial pain syndrome and fibromyalgia. Curr Pain Headache Rep 2003; 7(6): 433-42.
  6. Travell J, Simons D. Myofascial pain and dysfunction: The trigger point manual, the upper extremities. Philadelphia, PA: Williams and Wilkins; 1982.
  7. Simons DG, Travell JG, Simons LS. Travell and Simons' myofascial pain and dysfunction: Upper half of body. Philadelphia, PA: Lippincott Williams and Wilkins; 1999.
  8. Giles LG, Muller R. Chronic spinal pain syndromes: a clinical pilot trial comparing acupuncture, a nonsteroidal anti-inflammatory drug, and spinal manipulation. J Manipulative Physiol Ther 1999; 22(6): 376-81.
  9. Venancio RA, Alencar FG, Zamperini C. Different substances and dry-needling injections in patients with myofascial pain and headaches. Cranio 2008; 26(2): 96-103.
  10. Sciotti VM, Mittak VL, DiMarco L, Ford LM, Plezbert J, Santipadri E, et al. Clinical precision of myofascial trigger point location in the trapezius muscle. Pain 2001; 93(3): 259-66.
  11. Nagrale AV, Glynn P, Joshi A, Ramteke G. The efficacy of an integrated neuromuscular inhibition technique on upper trapezius trigger points in subjects with non-specific neck pain: a randomized controlled trial. J Man Manip Ther 2010; 18(1): 37-43.
  12. Itoh K, Katsumi Y, Hirota S, Kitakoji H. Randomised trial of trigger point acupuncture compared with other acupuncture for treatment of chronic neck pain. Complement Ther Med 2007; 15(3): 172-9.
  13. Kietrys DM, Palombaro KM, Azzaretto E, Hubler R, Schaller B, Schlussel JM, et al. Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis. J Orthop Sports Phys Ther 2013; 43(9): 620-34.
  14. Tabatabaiee A, Ebrahimi I, Ahmadi A, Sarrafzadeh J. Comparison between the effect of pressure release and dry needling on the treatment of latent trigger point of upper trapezius muscle. Physical Treatment 2013; 3(3): 9-15. [In Persian].
  15. Ziaeifar M, A'rab AM, Karimi N, Mosalla-Nezhad Z. The effect of dry needling compared with ischemic pressure on pain intensity on active trigger point in upper trapezius muscle. J Rehab 2013; 14(2): 86-92. [In Persian].
  16. Dommerholt J, Huijbregts P. Myofascial trigger points: pathophysiology and evidence-informed diagnosis and management. 1st ed. Burlington, MA: Jones and Bartlett Learning; 2009.
  17. Langevin HM, Bouffard NA, Badger GJ, Churchill DL, Howe AK. Subcutaneous tissue fibroblast cytoskeletal remodeling induced by acupuncture: evidence for a mechanotransduction-based mechanism. J Cell Physiol 2006; 207(3): 767-74.
  18. Braun BL. Postural differences between asymptomatic men and women and craniofacial pain patients. Arch Phys Med Rehabil 1991; 72(9): 653-6.
  19. Singer KP. A new musculoskeletal assessment in a student population. J Orthop Sports Phys Ther 1986; 8(1): 34-41.
  20. Tsauo JY, Lee HY, Hsu JH, Chen CY, Chen CJ. Physical exercise and health education for neck and shoulder complaints among sedentary workers. J Rehabil Med 2004; 36(6): 253-7.
  21. Edwards J. The importance of postural habits in perpetuating myofascial trigger point pain. Acupunct Med 2005; 23(2): 77-82.
  22. Falla D, O'Leary S, Fagan A, Jull G. Recruitment of the deep cervical flexor muscles during a postural-correction exercise performed in sitting. Man Ther 2007; 12(2): 139-43.
  23. Arain M, Campbell MJ, Cooper CL, Lancaster GA. What is a pilot or feasibility study? A review of current practice and editorial policy. BMC Med Res Methodol 2010; 10: 67.
  24. Vernon H. The Neck Disability Index: state-of-the-art, 1991-2008. J Manipulative Physiol Ther 2008; 31(7): 491-502.
  25. Ylinen J, Nykanen M, Kautiainen H, Hakkinen A. Evaluation of repeatability of pressure algometry on the neck muscles for clinical use. Man Ther 2007; 12(2): 192-7.
  26. Potter L, McCarthy C, Oldham J. Algometer reliability in measuring pain pressure threshold over normal spinal muscles to allow quantification of anti-nociceptive treatment effects. Int J Osteopath Med 2006; 9(4): 113-9.
  27. Fischer AA. Pressure algometry over normal muscles. Standard values, validity and reproducibility of pressure threshold. Pain 1987; 30(1): 115-26.
  28. Price DD, Bush FM, Long S, Harkins SW. A comparison of pain measurement characteristics of mechanical visual analogue and simple numerical rating scales. Pain 1994; 56(2): 217-26.
  29. Mousavi SJ, Parnianpour M, Montazeri A, Mehdian H, Karimi A, Abedi M, et al. Translation and validation study of the Iranian versions of the Neck Disability Index and the Neck Pain and Disability Scale. Spine (Phila Pa 1976) 2007; 32(26): E825-E831.
  30. Rickards LD. The effectiveness of non-invasive treatments for active myofascial trigger point pain: A systematic review of the literature. Int J Osteopath Med 2006; 9(4): 120-36.
  31. Alvarez DJ, Rockwell PG. Trigger points: diagnosis and management. Am Fam Physician 2002; 65(4): 653-60.
  32. Rayegani S M, Bayat M, Bahrami M H, Elyaspour D, Azhar A, Valaei N. Comparison of dry needling and physical therapy modalities in treatment of myofascial pain of upper trapezius muscle . Pajouhesh Dar Pezeshki 2010; 34(3): 157-63. [In Persian].
  33. Tsai CT, Hsieh LF, Kuan TS, Kao MJ, Chou LW, Hong CZ. Remote effects of dry needling on the irritability of the myofascial trigger point in the upper trapezius muscle. Am J Phys Med Rehabil 2010; 89(2): 133-40.
Journal of Research in Rehabilitation Sciences
Volume 12, Issue 4 - Serial Number 4
September 2016
Pages 235-242