Dry needling for myofascial pain

Dry-needling is a technique that uses needles to treat myofascial pain in any body part, including the low-back region

• myofascial pain syndrome is a disease of muscle that produces local and referred pain
  • characterized by a motor abnormality (a hard band within the muscle) and by sensory abnormalities (tenderness and referred pain)
    
    
• dry-needling involves the insertion of a needle (it can be an acupuncture needle or any other injection needle without injecting any liquid) at these trigger points
  • the needles are not left in situ, they are removed once the trigger point is inactivated
  • the inactivation of the trigger point should be followed by exercises (usually stretching) or ergonomic adjustments with the purpose to re-establish a painless, full range of motion, and avoid recurrences
    
    
• unclear what exact mechanisms underlying the action of acupuncture or dry-needling
  • been suggested that acupuncture might act by principles of the gate control theory of pain. One type of sensory input (low-back pain) could be inhibited in the central nervous system by another type of input (needling)
  • another theory, the diffuse noxious inhibitory control (DNIC), implies that noxious stimulation of heterotopic body areas modulates the pain sensation originating in areas where a subject feels pain
    
    
• evidence:
  • a systematic review concluded that "...data suggest that acupuncture and dry-needling may be useful adjuncts to other therapies for chronic low-back pain. Because most of the studies were of lower methodological quality, there certainly is a further need for higher quality trials in this area..."

Reference:

• 1) Furlan AD, van Tulder MW, Cherkin DC, Tsukayama H, Lao L, Koes BW, Berman BM. Acupuncture and dry-needling for low back pain. Cochrane Database Syst Rev. 2005 Jan 25;(1):CD001351.