What is the efficacy of dry needling for the treatment of myofascial pain (MPS)?

Updated: Nov 03, 2020
  • Author: Stephen Kishner, MD, MHA; Chief Editor: Erik D Schraga, MD  more...
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Answer

Pain from myofascial trigger points is often treated by needling, with or without injection, though the evidence is inconclusive on whether this is effective. A literature review examined seven studies that assessed the effects of dry needling. [3]  One study concluded that direct dry needling was superior to no intervention; two studies comparing direct dry needling to needling elsewhere in the muscle produced contradictory results; and four studies used a placebo control and were included in a meta-analysis.

Upon analysis of these studies, needling was not found to be significantly superior to placebo; however, marked statistical heterogeneity was present. [3]  Thus, this review found limited evidence deriving from only a single study that deep needling directly into myofascial trigger points has an overall treatment effect when compared with standardized care.

In a 2013 systematic review and meta-analysis of 12 randomized, controlled trials designed to assess the effectiveness of dry needling for upper-quarter myofascial pain (MPS), Kietrys et al reported the following findings [4] :

  • Evidence from three studies of dry needling vs placebo suggested that dry needling could immediately decrease pain in patients with upper-quarter MPS; there was an overall effect in favor of dry needling
  • Evidence from two studies of dry needling vs placebo suggested that dry needling could decrease pain after 4 weeks in patients with upper-quarter MPS; the impact of this decrease was limited by the wide confidence interval for the overall effect
  • Studies of dry needling vs other treatments yielded highly heterogeneous results; evidence from two studies suggested that lidocaine injection may be more effective in reducing pain than dry needling at 4 weeks

On the basis of these findings, the authors of the meta-analysis recommended dry needling, as compared with sham or placebo, for decreasing pain immediately after treatment and at 4 weeks in patients with upper-quarter MPS. [4]


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