Evidence for Dry Needling in the Management of Myofascial Trigger Points Associated with Low Back Pain: A Systematic Review and Meta-analysis

Publication date: Available online 8 July 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Lin Liu, Qiang-Min Huang, Qing-Guang Liu, Nguyen Thitham, Li-Hui Li, Yan-Tao Ma, Jia-Min Zhao
ObjectiveTo evaluate the current evidence of the effectiveness of dry needling of myofascial trigger points (MTrPs) associated with low back pain (LBP).Data SourcesPubMed, Ovid, EBSCO, ScienceDirect, Web of Science, Cochrane Library, Cumulative Index to Nursing and Allied Health, and China National Knowledge Infrastructure databases were searched until January 2017.Study SelectionRandomized controlled trials (RCTs) that used dry needling as the main treatment and included participants diagnosed with LBP with the presence of MTrPs were included.Data ExtractionTwo reviewers independently screened articles, scored methodological quality, and extracted data. The primary outcomes were pain intensity and functional disability at post-intervention and follow-up.Data SynthesisA total of 11 RCTs involving 802 patients were included in the meta-analysis. Results suggested that compared with other treatments, dry needling of MTrPs was more effective in alleviating the intensity of LBP (Standardized Mean Difference [SMD] = −1.06, 95% Confidence Interval [CI]: −1.77 to −0.36, P = 0.003) and functional disability (SMD = −0.76, 95% CI: −1.46 to −0.06, P = 0.03); however, the significant effects of dry needling plus other treatments on pain intensity could be superior to dry needling alone for LBP at post-intervention (SMD = 0.83, 95% CI: 0.55 to 1.11, P < 0.00001).ConclusionsModerate evidence showed that dry needling of MTrPs, especially if associated with other therapies, could be recommended to relieve the intensity of LBP at post-intervention; however, the clinical superiority of dry needling in improving functional disability and its follow-up effects still remain unclear.



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