Brown Jace, Kearns Gary, Brizzolara Kelli, Weber Mark, Wang-Price Sharon
School of Physical Therapy, Texas Woman's University, Dallas, TX, USA.
Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
J Man Manip Ther. 2025 Aug;33(4):299-308. doi: 10.1080/10669817.2025.2464542. Epub 2025 Feb 10.
Individuals with shoulder pain have a higher occurrence of myofascial trigger points (MTrPs). In the past decade, dry needling (DN) has been used in physical therapy practice to treat MTrPs. Impaired blood flow is proposed as an underlying mechanism of MTrPs in neck-shoulder pain. However, whether DN would improve muscle blood flow in individuals with shoulder pathology has not been examined. Therefore, the primary purpose of this study was to use color Doppler imaging to examine the effects of DN on the blood flow of the infraspinatus muscle in individuals with shoulder pain. The secondary purpose was to examine the effects of DN on sensitivity to pressure and shoulder range of motion (ROM) of the infraspinatus muscle in individuals with shoulder pain.
This randomized comparison trial utilized a sham-controlled design. Forty individuals with nonspecific shoulder pain and at least one MTrP in the infraspinatus muscle were randomly assigned to a real DN group or a sham DN group. Outcome measures, including blood flow parameters, ROMs of shoulder internal rotation and external rotation, and pressure pain threshold (PPT) were collected before and immediately after a single session of DN.
The repeated measure ANOVA results revealed that real DN significantly decreased peak systolic velocity (PSV) and increased shoulder internal and external rotation ROM more than sham DN ( < 0.05). However, there were no significant differences in end diastolic velocity, resistive index, pulsatile index, and PPTs between real DN and sham DN ( > 0.05).
The results indicated that participants who received real DN exhibited a significant reduction in PSV, suggesting improved blood flow to the infraspinatus muscle. Participants who received real DN exhibited improvements in shoulder ROM but showed no reductions in sensitivity to pressure. These results may provide clinicians with evidence for the use of DN for individuals with shoulder pain.
肩部疼痛患者肌筋膜触发点（MTrP）的发生率较高。在过去十年中，物理治疗实践中已采用干针疗法（DN）来治疗MTrP。血流受损被认为是颈肩痛中MTrP的潜在机制。然而，DN是否会改善肩部病变患者的肌肉血流尚未得到研究。因此，本研究的主要目的是使用彩色多普勒成像来检查DN对肩部疼痛患者冈下肌血流的影响。次要目的是检查DN对肩部疼痛患者冈下肌压力敏感性和肩部活动范围（ROM）的影响。
本随机对照试验采用假对照设计。40例非特异性肩部疼痛且冈下肌至少有一个MTrP的患者被随机分为真DN组或假DN组。在单次DN治疗前和治疗后立即收集包括血流参数、肩部内旋和外旋ROM以及压力疼痛阈值（PPT）在内的结果指标。
重复测量方差分析结果显示，与假DN相比，真DN显著降低了收缩期峰值速度（PSV），并增加了肩部内旋和外旋ROM（<0.05）。然而，真DN和假DN在舒张末期速度、阻力指数、搏动指数和PPT方面没有显著差异（>0.05）。
结果表明，接受真DN治疗的参与者PSV显著降低，表明冈下肌血流得到改善。接受真DN治疗的参与者肩部ROM有所改善，但压力敏感性没有降低。这些结果可能为临床医生将DN用于肩部疼痛患者提供证据。
