The effect of dry needling for myofascial trigger points in the neck and shoulders: A systematic review and meta-analysis

Background and purpose: The aim of this systematic review with meta-analysis is to determine the effect of dry needling in the treatment of MTrPs. Methods: Searches were performed using the electronic databases AMED, EBM reviews, Embase, and Ovid MEDLINE (all from database inception-February 2012). Study selection: Randomized controlled trials (RCTs) were included if they compared dry needling with another form of treatment or placebo and included pain intensity as an outcome. Data extraction: Two blinded reviewers independently screened the articles, scored their methodological quality and extracted data. Quality assessment: Physiotherapy Evidence Database (PEDro) quality scale and the Cochrane risk of bias tool were used. Results: Four RCTs compared dry needling to lidocaine and one RCT compared dry needling to placebo. Meta-analyses of dry needling revealed no significant difference between dry needling and lidocaine immediately after treatment standardized mean difference (SMD) 0.41 (95%CI −0.15 to 0.97), at one month (SMD −1.46; 95% CI −2.04 to 4.96) and three to six months (SMD −0.28; 95% CI −0.63 to 0.07). Discussion: Although not significant in the meta-analyses, there were interesting patterns favoring lidocaine immediately after treatment and dry needling at three to six months.