Dry Needling - Efficacy

Efficacy

Just like there are various methods to dry needling, there are various theories concerning the mechanism of action in how or why the procedure may work. Many of the studies published about dry needling are not strong; either the studies were not randomized, contained small sample sizes, had high dropout rates, used active interventions in the control group, did not follow the minimally acceptable criteria for diagnosing a myofascial trigger point, or did not clearly state that myofascial trigger points were the sole cause for the pain. For example, in a systematic review on needling therapies in the management of myofascial trigger points, only 8 of the 23 trials described the minimally acceptable criteria for diagnosing a trigger point. Locating the trigger point for dry needling is the basis for performing dry needling and should therefore be documented in each study performing this technique. In the same review, two studies tested the efficacy beyond placebo of dry needling in the treatment of myofascial trigger point pain, but, in one, the dropout rate was 48% and it was neither blinded nor randomized, and the other study used potentially active interventions in the control group.

Another systematic review concluded that dry needling for the treatment of myofascial pain syndrome in the lower back appeared to be a useful addition to standard therapies, but that clear recommendations could not be made because the published studies are small and of low quality. A 2007 meta-analysis examining dry needling of myofascial trigger points concluded that the effect of needling was not significantly different to that of placebo controls, though the trend in the results could be compatible with a treatment effect. One study (Lorenzo et al. 2004) did show a short-term reduction in shoulder pain in stroke patients who received needling with standard rehabilitation compared to those who received standard care alone, but the study was open-label and measurement timings differed, limiting the use of the study. Again the small sample size and poor quality of studies was highlighted.