Table 5.

Adverse events described in the included studies.

Ibuldu et al. 2004 [36]	No data about adverse events were provided.
Itoh et al. 2007 [33]	One patient in the sham group was excluded due to deterioration of symptoms. No adverse events were observed during treatment.
Myburgh et al. 2012 [27]	Within the DN group, 5 patients (29.4%) perceived post-needling soreness, and 8 patients (47.1%) perceived muscle strength soreness (diffuse muscle fatigue) 48 hours postintervention. Within the sham needling group, 9 patients (45%) experienced post-needling soreness.
Tekin et al. 2012 [46]	No data about adverse events were provided.
Rayegani et al. 2014 [51]	No data about adverse events were provided.
Llamas-Ramos et al. 2014 [32]	Twenty-six patients (55%) assigned to DN group experienced post-needling soreness. Eleven patients assigned to manual therapy group experienced muscle fatigue. All minor adverse events resolved spontaneously within 24-48 h without further treatment.
Ziaeifar et al. 2014 [35]	No data about adverse events were provided.
Mejuto-Vázquez et al. 2014 [28]	Eighty-eight percent (88%) of patients assigned in the DN group experienced post-needling soreness. This minor adverse event resolved spontaneously within 24-36 h without further treatment.
Campa-Moran et al. 2015 [41]	No adverse effect was registered after the needling application.
Pecos-Martín et al. 2015 [25]	No data about adverse events were provided.
Aridici et al. 2016 [42]	No data about adverse events were provided.
Segura-Ortí et al. 2016 [50]	Two subjects assigned to the DN group dropped out due to aversion to needles. No other adverse event was observed.
Hayta et al. 2016 [37]	No data about adverse events were provided.
Ziaeifar et al. 2016 [23]	No data about adverse events were provided.
Sobhani et al. 2017 [49]	No data about adverse events were provided.
Fernández-Carnero et al. 2017 [38]	Ninety-one percent (91%) of the patients reported post-needling soreness. No other adverse effects were reported
De Meulemeester et al. 2017 [40]	Post-needling soreness. No other adverse effects were reported.
Luan et al. 2019 [31]	No adverse effects were observed during the study.
Dogan et al. 2019 [39]	No adverse effects were observed during the study.
Manafnezhad et al. 2019 [30]	No data about adverse events were provided.
Martín-Rodríguez et al. 2019 [29]	Within the non-trigger point DN group, three patients (17.6%) experimented contralateral side pain, 4 patients (23.5%) suffered headache, one patient (5.9%) earache, and one (5.9%) hematoma. Within the trigger point DN group, three patients (17.6%) experimented contralateral side pain and one patient (2.9%) post-needling soreness.
Tabatabaiee et al. 2019 [47]	No data about adverse events were provided.
Onat et al. 2019 [26]	Three patients (8.3%) in the DN group experienced an increase in neck pain after dry needling, and 2 patients (5.5%) in the Kinesiotaping group showed cutaneous irritation.
Ziaeifar et al. 2019 [24]	No data about adverse events were provided.
Sukareechai et al. 2019 [48]	Some participants experienced soreness after dry needling therapy.
Arias-Buría et al. 2020 [43]	Six patients assigned to the DN experienced post-needling soreness, but it resolved spontaneously.
Valiente-Castrillo et al. 2020 [45]	Ninety percent (90%) patients presented post-needling soreness after DN, but it resolved spontaneously.
García-de-Miguel et al. 2020 [44]	No data about adverse events were provided.

DN: Dry Needling.