Martín-Pintado-Zugasti Aitor, Mayoral Del Moral Orlando, Gerwin Robert D, Fernández-Carnero Josue
Department of Physical Therapy, Faculty of Medicine, CEU-San Pablo University, Madrid, Spain.
Physical Therapy Department, Hospital Provincial, Toledo, Spain.
J Bodyw Mov Ther. 2018 Oct;22(4):941-946. doi: 10.1016/j.jbmt.2018.01.003. Epub 2018 Jan 17.
Post-dry needling soreness is a common complication of myofascial trigger point (MTrP) dry needling treatment. The prevention, management and relevance of this complication remain uncertain. This paper examines the current state of knowledge and suggests directions for further studies in this area. MTrPs are hypersensitive nodules in skeletal muscles' taut bands, present in several pain conditions. Dry needling has been recommended for relieving MTrP pain. MTrP dry needling procedures have shown to be associated with post-needling soreness, which is thought to be a consequence of the neuromuscular damage, and hemorrhagic and inflammatory reaction generated by the needle. Postneedling soreness is a very frequent effect after deep dry needling, usually lasting less than 72 h. It may not be especially distressing for most patients. However, patients presenting with higher levels of post-needling soreness, not perceiving dry needling effectiveness in the first session, or not having high myofascial pain intensity before treatment, could be the most likely to find post-needling soreness more distressing, functionally limiting and to abandon treatment. Future research should assess the clinical relevance of post-needling soreness. Post-needling soreness should be considered when investigating dry needling effectiveness since it could overlie the original myofascial pain and influence the patients' pain ratings.
干针后酸痛是肌筋膜触发点（MTrP）干针治疗常见的并发症。该并发症的预防、处理及相关性仍不明确。本文审视了当前的知识现状，并提出了该领域进一步研究的方向。MTrP是骨骼肌紧张带中的超敏结节，存在于多种疼痛病症中。干针疗法被推荐用于缓解MTrP疼痛。MTrP干针操作已显示与针后酸痛有关，针后酸痛被认为是神经肌肉损伤以及针刺产生的出血和炎症反应的结果。针后酸痛是深部干针治疗后非常常见的效应，通常持续少于72小时。对大多数患者来说，它可能不会特别令人苦恼。然而，针后酸痛程度较高、在首次治疗中未感受到干针疗效或治疗前肌筋膜疼痛强度不高的患者，最有可能觉得针后酸痛更令人苦恼、对功能有限制并放弃治疗。未来的研究应评估针后酸痛的临床相关性。在研究干针疗效时应考虑针后酸痛，因为它可能掩盖原有的肌筋膜疼痛并影响患者的疼痛评分。
