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Immediate effects of dry needling and myofascial release on local and widespread pressure pain threshold in individuals with active upper trapezius trigger points: a randomized clinical trial [with consumer summary]
Stieven FF, Ferreira GE, de Araujo FX, Angellos RF, Silva MF, da Rosa LHT
Journal of Manipulative and Physiological Therapeutics 2021 Feb;44(2):95-102
clinical trial
8/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

This study sought to compare the immediate effects of a single session of dry needling (DN), myofascial release (MR), and sham DN on pressure pain threshold (PPT) and neck pain intensity in individuals with chronic neck pain. This was a randomized trial with a blinded outcome assessor. Forty-four individuals with chronic neck pain and unilateral myofascial trigger points in the upper trapezius muscle (UTM) were randomized to receive DN (n = 15), MR (n = 14), or sham DN (n = 15). The PPT over the UTM (ipsilateral and contralateral sides) and the proximal head of the radius (ipsilateral and contralateral to the treated side) and neck pain were assessed immediately and 10 minutes after the intervention. There was no significant group x time interaction for PPT in the UTM on the treated side (F = 0.63, p = 0.641) or the contralateral side (F = 1.77, p = 0.144). However, there was a main effect of time on both the treated side (F = 4.917, p = 0001) and the contralateral side (F = 4.70, p = 0.015), with DN and MR increasing PPT at the UTM. No significant group x time x side interaction was found for PPT at the proximal head of the radius (F = 1.23, p = 0.276). Within-group analysis revealed a significant increase in PPT on the ipsilateral and contralateral sides in both DN and MR. Neck pain decreased after DN (p < 0.001), MR (p < 0.001), and sham DN (p = 0008). A single application of DN or MR generated local and distant hypalgesic responses superior to placebo. Future trials are needed to examine whether these findings occur in long-term follow-ups.
Reprinted from the Journal of Manipulative and Physiological Therapeutics with copyright permission from the National University of Health Sciences.

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