1352 - A Systematic Review and Meta-Analysis of Effectiveness and Safety on Dry Needling for Upper-Quarter Myofascial Pain

Objectives: Myofascial pain syndrome (MPS) is a common source of musculoskeletal pain and is often resistant to conventional treatments such as exercise and medication. Dry needling has emerged as a promising treatment option for upper-quarter MPS. Existing systematic reviews have limitations, leaving uncertainty about its effectiveness and safety. This systematic review and meta-analysis evaluated the effectiveness and safety of dry needling for upper-quarter MPS.

Design:
We searched seven databases and trial registries through June 26, 2024, for randomized trials comparing dry needling to sham or no intervention in adults (≥18 years) with upper-quarter MPS. We conducted random-effects meta-analyses for patient-important outcomes at short-term follow-up (0 to 24 hours after end of the intervention), medium-term follow-up (7 to 21 days), and long-term follow-up ( >21 days). We performed a priori subgroup analyses to explore heterogeneity and assessed the certainty of evidence using GRADE.



 

Results:
We included 10 trials (384 participants). The frequency and duration of dry needling interventions ranged from a single session to six sessions over four weeks. Compared to sham, moderate-certainty evidence shows that dry needling probably reduces pain at short-term follow-up by 2.41 points on a 10-point Visual Analogue Scale (VAS) (95% CI −3.20 to −1.63). A greater reduction was observed at medium-term follow-up (MD −2.67, CI −3.27 to −2.07; moderate-certainty). Results were robust to worst plausible assumptions regarding pain relief in studies with missing outcome data. No data were available at long-term follow-up. Reported adverse events were mild and transient.



 

Conclusions:

Dry needling likely reduces pain in patients with upper-quarter MPS at postintervention and short-term follow-up. Additional well-designed studies are needed to investigate the long-term effects of dry needling in treating myofascial pain syndrome.