Effects of dry needling trigger point therapy in the shoulder region on patients with upper extremity pain and dysfunction: a systematic review with meta-analysis.

QUESTION

What is the effectiveness and what are the adverse effects.

DESIGN

Systematic review with meta-analysis.

PARTICIPANTS

Patients with shoulder or upper extremity pain or dysfunction.

INTERVENTION

Trigger point dry needling (TDN) compared to control, another intervention or another needling technique.

OUTCOME MEASURES

Primary outcome measures included shoulder or upper limb pain, shoulder or upper limb dysfunction.

RESULTS

Eleven randomized trials involving 496 participants were appraised. There was very low evidence that trigger point dry needling of the shoulder region is effective for reducing pain and improving function in the short term. There is some evidence that needling both active and latent trigger points is more effective than needling an active trigger point alone for pain immediately and 1-week after treatment (SMD=-0.74, 95%CI=-1.2 to -0.3; and SMD=-1.0, 95%CI=-1.52 to -0.59).

CONCLUSION

There is very low evidence to support the use of TDN in the shoulder region for treating patients with upper extremity pain or dysfunction. Two studies reported adverse effects to TDN interventions. Most common adverse effects included bruising, bleeding, and pain during or after treatment. Future studies are likely to change the estimates of the effectiveness of TDN for patients with upper extremity pain or dysfunction.

PROSPERO

CRD42016045639.