Paraspinal Dry Needling
Wed, 8 Oct 2008
Robertshawe, Penny. "Comparison of dry needling with and without paraspinal needling for trigger points in elderly patients. " Journal of the Australian Traditional-Medicine Society. 14.1 (March 2008): 23(1). Academic OneFile. Gale. BCR Regis University. 8 Oct. 2008
<http://find.galegroup.com.dml.regis.edu/itx/infomark.do?&contentSet=IAC-Documents&type=retrieve&tabID=T002&prodId=AONE&docId=A177673202&source=gale&srcprod=AONE&userGroupName=regis&version=1.0>.
Full Text:COPYRIGHT 2008 Australian Traditional-Medicine Society
Hyuk GA, Choi J, Park C, Yoon H. Dry needling
of trigger points with and without paraspinal needling in myofascial
pain syndromes in elderly patients. Journal of Alternative and
Complementary Medicine 2007;13(6):617-623.
Why Was This Study Conducted?
The objective of this study was to compare the use of dry needling with and without paraspinal needling for the treatment of myofascial trigger points in elderly patients.
What Were The Parameters Of This Study?
Forty patients with an average age of 75 years were selected, and
all participants suffered from chronic myofascial pain syndrome in
their upper trapezius.
The participants were randomly divided into two groups. The first
group received dry needing of myofascial trigger points (DRY), and the
second group received both dry needling
of myofascial trigger points and intramuscular stimulation (IMS). There
were no significant differences between the two groups for age, gender
or body mass index.
All treatments were performed with the participant lying prone.
Members of the DRY group were needled backwards and forwards with an
acupuncture needle with the therapist holding the relative taut muscle
bands between the thumb and index finger. This action was repeated
until there were no more localised twitch responses.
The IMS group received the treatment described above, and additional
needling in the multifidi muscles at C3 and C5 level. The additional
needling was done using a different method from the 'pecking' method
used in dry needling. The IMS treatment involved first dry needling the muscle and then rotating it using a plunger-type needle holder until the therapist could feel a grasping in the muscle.
How Were The Measurements Taken?
Pain intensity in the head, neck and shoulder was measured using an
eleven point visual analogue scale (VAS) with 0 indicating no pain and
10 indicating extreme pain, and the six point Wong-Baker FACES pain
scale (FACES) with 0 indicating no pain and 5 indicating extreme pain.
Participants' pain pressure thresholds scores (PTS) were obtained
using thumb pressure on the trigger point until there was a whitening
in the nail bed and then evaluating the pain intensity. This was scored
on a scale of 0 to 3 with 0 indicating no pain or visible reaction, 1
some pain, 2 painful tenderness and visible facial reaction and 3
severe pain and a marked facial reaction.
Range of movement (ROM) was measured using a specialised measuring
device called a goniometer. The Geriatric Depression Scale-Short Form
(GDS-SF) was used on days 0 and 28 to measure depression.
What Were The Results?
The results showed significant improvements in pain intensity for
both groups in the VAS, FACES and PTS scores. There were no significant
differences between time and type of treatments between groups for VAS
and PTS, but FACE showed a borderline significance in favour of the IMS
group.
GDS-SF values showed no significant differences in the DRY group at
the end of the study. However, the IMS group showed a significant
improvement for depression.
All ROM measurements improved significantly in both groups except
for extension in the DRY group. There were no significant differences
between the two groups for levels or duration of post treatment
soreness. None of the participants showed visible signs of
hemorrhaging.
What Did The Researchers Conclude?
The researchers concluded that 'dry needling of trigger points with paraspinal needling is suggested to be a better method than dry needling
of trigger points only for treating myofascial pain syndrome in elderly
patients, but further studies are needed for verification'.
What Were The Limitations Of This Study?
The researchers highlighted two limitations. The first limitation
was that pain threshold measurements were taken using the thumb as
opposed to specialised equipment in the form of an algometer. The
second limitation was, with the exception of day 0, those responsible
for taking measurements were not blinded as to which treatment the
participants received.
