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Evidence for Dry Needling in the Management of Myofascial Trigger Points Associated With Low Back Pain: A Systematic Review and Meta-Analysis
Authors:Lin Liu  Qiang-Min Huang  Qing-Guang Liu  Nguyen Thitham  Li-Hui Li  Yan-Tao Ma  Jia-Min Zhao
Affiliation:1. Department of Sport Medicine and the Center of Rehabilitation, School of Sport Science, Shanghai University of Sport, Shanghai, China;2. Department of Pain Rehabilitation, Shanghai Hudong Zhonghua Shipbuilding Group Staff-worker Hospital, Shanghai, China
Abstract:

Objective

To evaluate the current evidence of the effectiveness of dry needling of myofascial trigger points (MTrPs) associated with low back pain (LBP).

Data Sources

PubMed, Ovid, EBSCO, ScienceDirect, Web of Science, Cochrane Library, CINAHL, and China National Knowledge Infrastructure databases were searched until January 2017.

Study Selection

Randomized controlled trials (RCTs) that used dry needling as the main treatment and included participants diagnosed with LBP with the presence of MTrPs were included.

Data Extraction

Two reviewers independently screened articles, scored methodologic quality, and extracted data. The primary outcomes were pain intensity and functional disability at postintervention and follow-up.

Data Synthesis

A total of 11 RCTs involving 802 patients were included in the meta-analysis. Results suggested that compared with other treatments, dry needling of MTrPs was more effective in alleviating the intensity of LBP (standardized mean difference [SMD], ?1.06; 95% confidence interval [CI], ?1.77 to ?0.36; P=.003) and functional disability (SMD, ?0.76; 95% CI, ?1.46 to ?0.06; P=.03); however, the significant effects of dry needling plus other treatments on pain intensity could be superior to dry needling alone for LBP at postintervention (SMD, 0.83; 95% CI, 0.55–1.11; P<.00001).

Conclusions

Moderate evidence showed that dry needling of MTrPs, especially if associated with other therapies, could be recommended to relieve the intensity of LBP at postintervention; however, the clinical superiority of dry needling in improving functional disability and its follow-up effects still remains unclear.
Keywords:Low back pain  Meta-analysis [publication type]  Needles  Randomized controlled trial as topic  Rehabilitation  Trigger points  CI  confidence interval  LBP  low back pain  MD  mean difference  MTrP  myofascial trigger point  fail-safe number  RCT  randomized controlled trial  SMD  standardized mean difference
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