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

Summary 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.