Published: 2018-07-25

Immediate and delayed effect of dry needling in musculoskeletal disorders: a quasi experimental study

Riyas Basheer K. B., Jazeel N. M., Harish S. Krishna, Veena K. S., Madhuripu P., Sreejisha P. K., Dainy Varghese


Background: The roles of physiotherapists in managing the chronic and acute pain in musculoskeletal (Msk) conditions are inevitable now days. Physiotherapists work across the time period aiding patients with their pain in medical care settings with the aim of decreasing pain, rising quality of life wherever attainable and preventing acute and sub-acute painful conditions developing into chronic pain. Dry needling, an invasive technique in the hand of Physios is a new trend in managing acute and chronic pain. Purpose of the study is to identify the immediate and delayed response of pain and presence of soreness after the dry needling in common Msk conditions which can be managed in association with other conventional physical therapy techniques. Objective was to find out the immediate and delayed effects of dry needling over pain in musculoskeletal disorders.

Methods: This study was carried out in the department of physiotherapy, Malabar medical college hospital and research centre. Patient was prepared and identified the extreme tender point over the muscle affected and needle removed after 3-5 twitch response elicited. Sterility of the treatment area and needle was well maintained. Prior to the treatment again confirmed with the NPRS score and procedure was done. After few seconds of insertion of needle subjects NPRS score assessed. After removal of needling pain score was assessed after 5 mins, 30 mins, 1 hour and after one day.

Results: Study showed a marked reduction in pain after dry needling at each intervals and this suggesting promoting dry needling as an adjunct to pain relief technique in physiotherapy.

Conclusions: Dry needling is effective over pain in musculoskeletal disorders.


Dry needling, Pain, Musculoskeletal disorder, NPRS, Trigger point

Full Text:



Skootsky SA, Jaeger B, Oye RK. Prevalence of myofascial pain in general internal medicine practice. West J Med. 1989;151:157-60.

Lavelle ED, Lavelle W, Smith HS. Myofascial trigger points. Med Clin N Am. 2007;91:229-39.

Hong CZ. Lidocaine injection versus dry needling to myofascial trigger point. The importance of the local twitch response. Am J Phys Med Rehabil. 1994;73:256-63.

Barbagli P, Bollettin R, Ceccherelli F. Acupuncture (dry needle) versus neural therapy (local anesthesia) in the treatment of benign back pain. Immediate and long-term results. Minerva Med. 2003;94:17-25.

Ga H, Choi JH, Park CH, Yoon HJ. Acupuncture needling versus lidocaine injection of trigger points in myofascial pain syndrome in elderly patients-a randomised trial. Acupunct Med. 2007;25:130-6.

Sterling M, Valentin S, Vicenzino B, Souvlis T, Connelly LB. Dry needling and exercise for chronic whiplash-a randomised controlled trial. BMC Musculoskelet Disord. 2009;10:160.

Huguenin L, Brukner PD, McCrory P, Smith P, Wajswelner H, Bennell K. Effect of dry needling of gluteal muscles on straight leg raise: a randomised, placebo controlled, double blind trial. British J Sports Medicine. 2005;39:84-90.

Goddard G, Karibe H, McNeill C, Villafuerte E. Acupuncture and sham acupuncture reduce muscle pain in myofascial pain patients. Journal of Orofacial Pain. 2002;16:71-6.

Lewit K. The needle effect in the relief of myofascial pain. Pain. 1979;6:83-90.

Simons DG, Travell JG, Simons PT. Travell and Simons' myofascial pain and dysfunction: the trigger point manual. Williams and Wilkins, Baltimore. 1999:11-93.

Gunn CC. The Gunn approach to the treatment of chronic pain; intramuscular stimulation for myofascial pain of radiculopathic origin. Churchill Livingston, New York. 1996:11-37.

Cummings TM, White AR. Needling therapies in the management of myofascial trigger point pain: a systematic review. Arch Phys Med Rehabil. 2001;82:986-92.

King JC, Goddard MJ. Pain rehabilitation: chronic pain syndrome and myofascial pain syndrome. Arch Phys Med Rehabil. 1994;75:9-14.

Ceccherelli F, Rigoni MT, Gagliardi G, Ruzzante L. Comparison of superficial and deep acupuncture in the treatment of lumbar myofascial pain: a double-blind randomized controlled study. Clin J Pain. 2002;18:149-53.

Itoh K, Katsumi Y, Kitakoji H. Trigger point acupuncture treatment of chronic low back pain in elderly patients-a blinded RCT. Acupunct Med. 2004;22:170-7.

Hong CZ. Persistence of local twitch response with loss of conduction to and from the spinal cord. Arch Phys Med Rehabil. 1994;75:12-6.

Chen JT, Chung KC, Hou CR, Kuan TS, Chen SM, Hong CZ. Inhibitory effect of dry needling on the spontaneous electrical activity recorded from myofascial trigger spots of rabbit skeletal muscle. Am J Phys Med Rehabil. 2001;80:729-35.

Itoh K, Minakawa Y, Kitakoji H. Effect of acupuncture depth on muscle pain. Chin Med. 2011;6(1):24.