University of Bridgeport College of Health Sciences, School of Chiropractic, 126 Park Avenue, Bridgeport, CT, 06604, USA.
Chiropr Man Therap. 2020 May 11;28(1):23. doi: 10.1186/s12998-020-00310-z.
INTRODUCTION/BACKGROUND: The depth and breadth of research on dry needling (DN) has not been evaluated specifically for symptomatic spine related disorders (SRD) from myofascial trigger points (TrP), disc, nerve and articular structures not due to serious pathologies. Current literature appears to support DN for treatment of TrP. Goals of this review include identifying research published on DN treatment for SRD, sites of treatment and outcomes studied.
A scoping review was conducted following Levac et al.'s five part methodological framework to determine the current state of the literature regarding DN for patients with SRD.
Initial and secondary search strategies yielded 55 studies in the cervical (C) region (71.43%) and 22 in the thoracolumbar-pelvic (TLP) region (28.57%). Most were randomized controlled trials (60% in C, 45.45% in TLP) and clinical trials (18.18% in C, 22.78% in TLP). The most commonly treated condition was TrP for both the C and TLP regions. In the C region, DN was provided to 23 different muscles, with the trapezius as treatment site in 41.88% of studies. DN was applied to 31 different structures in the TLP region. In the C region, there was one treatment session in 23 studies (41.82%) and 2-6 treatments in 25 (45.45%%). For the TLP region, one DN treatment was provided in 8 of the 22 total studies (36.36%) and 2-6 in 9 (40.9%). The majority of experimental designs had DN as the sole intervention. For both C and TLP regions, visual analogue scale, pressure pain threshold and range of motion were the most common outcomes.
For SRD, DN was primarily applied to myofascial structures for pain or TrP diagnoses. Many outcomes were improved regardless of diagnosis or treatment parameters. Most studies applied just one treatment which may not reflect common clinical practice. Further research is warranted to determine optimal treatment duration and frequency. Most studies looked at DN as the sole intervention. It is unclear whether DN alone or in addition to other treatment procedures would provide superior outcomes. Functional outcome tools best suited to tracking the outcomes of DN for SRD should be explored.
简介/背景：从肌筋膜触发点（TrP）、椎间盘、神经和关节结构对非严重病变相关的症状性脊柱疾病（SRD）进行的干针治疗（DN）的深度和广度尚未得到专门评估。目前的文献似乎支持 DN 治疗 TrP。本综述的目标包括确定发表的关于 DN 治疗 SRD 的研究，治疗部位和研究的结果。
根据 Levac 等人的五部分方法框架进行了范围综述，以确定有关 DN 治疗 SRD 患者的文献现状。
初步和二次搜索策略在颈椎（C）区产生了 55 项研究（71.43%），在胸腰椎-骨盆（TLP）区产生了 22 项研究（28.57%）。大多数是随机对照试验（C 区 60%，TLP 区 45.45%）和临床试验（C 区 18.18%，TLP 区 22.78%）。最常治疗的疾病是 C 和 TLP 区的 TrP。在 C 区，DN 用于 23 种不同的肌肉，斜方肌作为治疗部位占 41.88%。DN 用于 TLP 区 31 种不同的结构。在 C 区，23 项研究中有 1 项治疗（41.82%），25 项研究中有 2-6 项治疗（45.45%）。对于 TLP 区，22 项研究中有 8 项（36.36%）进行了 1 次 DN 治疗，9 项（40.9%）进行了 2-6 次治疗。大多数实验设计将 DN 作为唯一干预措施。对于 C 和 TLP 区，视觉模拟评分、压力疼痛阈值和运动范围是最常见的结果。
对于 SRD，DN 主要应用于肌筋膜结构，用于疼痛或 TrP 诊断。无论诊断或治疗参数如何，许多结果都得到了改善。大多数研究仅应用了一种治疗方法，这可能无法反映常见的临床实践。需要进一步研究以确定最佳治疗持续时间和频率。大多数研究都将 DN 作为唯一干预措施。尚不清楚 DN 单独或与其他治疗程序一起是否会提供更好的结果。应探索最适合跟踪 SRD 中 DN 结果的功能结果工具。
