Detailed Search Results
| Author/Association: | Gattie E, Cleland JA, Snodgrass S |
| Title: | The effectiveness of trigger point dry needling for musculoskeletal conditions by physical therapists: a systematic review and meta-analysis [with consumer summary] |
| Source: | The Journal of Orthopaedic and Sports Physical Therapy 2017 Mar;47(3):133-149 |
| Method: | systematic review |
| Method Score: | This is a systematic review. Systematic reviews are not rated. |
| Consumer Summary: | KEY POINTS: FINDINGS: Very low- to moderate-quality evidence suggests that dry needling performed by physical therapists is more effective than no treatment, sham dry needling, or other treatments for reducing pain and improving PPT in patients presenting with musculoskeletal pain in the immediate to 12-week follow-up period. Very low- to low-quality evidence suggests superior outcomes with dry needling for functional outcomes when compared to no treatment or sham needling, but no difference in functional outcomes when compared to other physical therapy treatments. Evidence of the long-term benefit of dry needling is currently lacking. IMPLICATIONS: Dry needling appears to be at least as effective as other treatments included in this review, and more effective than sham or no treatment for reducing pain and increasing PPT during the immediate to 12-week treatment period in patients with musculoskeletal pain. CAUTION: The overall quality and limited number of studies reporting on dry needling performed by physical therapists at this time, combined with the high heterogeneity found in the results of the meta-analyses, indicate that readers should use caution when interpreting these results. |
| Abstract: | STUDY DESIGN: Systematic review and meta-analysis. BACKGROUND: An increasing number of physical therapists in the United States and throughout the world are using dry needling to treat musculoskeletal pain. OBJECTIVE: To examine the short- and long-term effectiveness of dry needling delivered by a physical therapist for any musculoskeletal pain condition. METHODS: Electronic databases were searched. Eligible randomized controlled trials included those with human subjects who had musculoskeletal conditions that were treated with dry needling performed by a physical therapist, compared with a control or other intervention. The overall quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation. RESULTS: The initial search returned 218 articles. After screening, 13 were included. Physiotherapy Evidence Database quality scale scores ranged from 4 to 9 (out of a maximum score of 10), with a median score of 7. Eight meta-analyses were performed. In the immediate to 12-week follow-up period, studies provided evidence that dry needling may decrease pain and increase pressure pain threshold when compared to control/sham or other treatment. At 6 to 12 months, dry needling was favored for decreasing pain, but the treatment effect was not statistically significant. Dry needling, when compared to control/sham treatment, provides a statistically significant effect on functional outcomes, but not when compared to other treatments. CONCLUSION: Very low-quality to moderate-quality evidence suggests that dry needling performed by physical therapists is more effective than no treatment, sham dry needling, and other treatments for reducing pain and improving pressure pain threshold in patients presenting with musculoskeletal pain in the immediate to 12-week follow-up period. Low-quality evidence suggests superior outcomes with dry needling for functional outcomes when compared to no treatment or sham needling. However, no difference in functional outcomes exists when compared to other physical therapy treatments. Evidence of long-term benefit of dry needling is currently lacking. LEVEL OF EVIDENCE: Therapy, level 1a. Full text (sometimes free) may be available at these link(s):  help |
