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. 2016 Feb;11(1):1–14.

Table 2.

Summary of included studies

Study Purpose of Study Participants Intervention Time Frame of Study Outcome Measures and Tests Results
Cotchett et al47 To evaluate how effective trigger point dry needling is as a treatment for plantar heel pain. The study included 84 patients, >18 y.o. with plantar heel pain with symptom duration of at least one month. Patients received either sham or real dry needling for 1 treatment per week, 30 minutes duration, for 6 weeks to the gastroc-soleus complex, quadratus plantae, flexor digitorum brevis, and abductor hallucis. Each needle was inserted for 5 minutes. The subjects participated for 6 weeks and were followed for 12 weeks. Outcomes were measured at 2, 4, 6, and 12 weeks.

  1. Visual Analog Scale (VAS)

  2. Foot Health Questionnaire (FHSQ)

  3. Short-Form (SF-36) for QoL

  4. Depression Anxiety and Stress Scales (DASS-21)

  5. Foot Posture Index

  6. Credibility Expectancy Questionnaire (CEQ)

  7. Physical Activity Recall (PAR)

 Both groups had decreased pain after 12 weeks, evident by the statistically significant differences in VAS (p < 0.007) and FHSQ (p < 0.026) scores. Overall, real dry needling was favored over sham dry needling.
Edwards et al3 To evaluate the effectiveness of combining superficial dry needling with active stretching for deactivating TrPs. The study included 40 subjects, mostly female, with an active TrP. The TrP was most commonly reported in the upper body. The subjects were divided into three groups: needling and stretching (13), stretching only (13), and control (13). The average number of dry needling sessions was 3.7. The needles were kept subcutaneously for an average of 3.4 minutes. The groups received treatment for 3 weeks and had no treatment for the subsequent 3 weeks.

  1. Short Form McGill Pain Questionnaire (SFMPQ), including a VAS component.

  2. Pressure Pain Threshold (PPT)

 The dry needling and stretching group required fewer follow-up visits after the study compared to the other groups. The mean number of treatment sessions was lower for the stretching only group (2.9) compared to needling and stretching group (4.6). SFMPQ decreased (p < 0.009) and PPT increased (p < 0.10) in the needling-stretching group.
Huguenin et al14 To evaluate placebo and therapeutic dry needling on SLR††, pain, tightness, and hip IR in male athletes with posterior thigh pain due to TrPs. The study included 85 male runners (59 completed measures before and after intervention, 58 completed the measures at 24 hours, and 52 completed the measures at 72 hours) with posterior thigh pain. The subjects received either therapeutic or placebo dry needling to gluteal TrPs on one occasion. Outcome measures were collected before treatment, immediately after, 24 hours post, and 72 hours post treatment for a total of 3 days for the study.

  1. VAS for pain

  2. ROM‡ of hamstring muscle with passive straight leg raise and hip IR§

 No significant change in VAS scores for gluteal pain after running, but both groups improved in hamstring tightness (p < 0.001) and hamstring pain (p < 0.001). There was no significant change in ROM. Patient report was a good indicator of dry needling success.
Itoh et al48 To determine whether acupuncture at TrPs is more effective than standard acupuncture for treating chronic low back pain in the geriatric population. The study included 35 subjects (25 women, 10 men) age 65-81 with chronic low back pain. Subjects were divided evenly into three groups: standard acupuncture, superficial acupuncture, and deep acupuncture. They received treatment to posterior thigh, gluteal, and lumbar musculature. There were a total of 6 30-minute treatment sessions, once per week. The study was conducted over 12 weeks with two phases of treatment, each lasting 3 weeks.

  1. VAS for pain

  2. Roland Morris Questionnaire (RMQ)

 The group that received dry needling to deep TrPs reported less pain intensity (p < 0.5) and improved QoL (p < 0.01), compared to the other groups.
MacDonald et al50 To examine the effectiveness of superficial acupuncture compared to placebo in the treatment of chronic low back pain. The study included 17 subjects (12 female, 5 male) with chronic low back pain. Eight subjects received acupuncture and 9 received placebo dry needling. Needles were inserted 4mm into the skin over TrPs for 5 minutes in the acupuncture group. The placebo group received electrical transcutaneous stimulation to the lumbar region. Treatments were performed once per week for a maximum of 10 weeks. The number of treatments was reduced if further improvement failed to occur or if symptoms worsened in response to treatment. No specific outcome measures were used, however, pain was assessed numerically (1- minimal, 2- moderate, 3-severe), area of pain was mapped on a dermatome body chart, and mood was measured from 1 (normal) to 5 (abnormal state). The acupuncture group had pain relief (p < 0.01), reduction in pain activity score NS#, decreased physical signs (p < 0.01), and decreased pain severity (p < 0.01) compared to the placebo group. The measurements were statistically significant with p < 0.05.
Mayoral et al49 To examine the effectiveness of dry needling to placebo in the prevention of pain after a total knee arthroplasty. The study included 40 subjects (29 female, 11 male) with a scheduled total knee replacement surgery and presence of TrPs. The subjects were assigned to a true dry needling group or a sham dry needling group. They were assessed prior to surgery and at months 1, 3, and 6 after surgery. Dry needling was applied under anesthesia. Subjects were examined prior to surgery and at 1, 3, and 6 months post-surgery.

  1. VAS for pain

  2. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)

  3. ROM

  4. Peak isometric strength of knee extensors and flexors

 Subjects who received true dry needling had less pain at 1 month with statistical significant differences in the VAS (p = 0.294). There was no statistical significance between groups for the WOMAC (p = 0.837 pain, p = 0.805 stiffness, p = 0.149 function) or ROM (p = 0.539) at baseline.

QoL = Quality of Life; TrP = Trigger Point; TrPs = Trigger Points; ROM = Range of Motion; IR = Internal Rotation; SLR = Straight Leg Raise; NS = Not Significant