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Efficacy of myofascial trigger point dry needling

Efficacy of myofascial trigger point dry needling in the prevention of pain after total knee arthroplasty: a randomized, double-blinded, placebo-controlled trial.

We all know that physical therapy before a total knee replacement improves the rehab after the total knee replacement surgery. I was pleasantly surprised when I came across this abstract showing that dry needle intervention before the surgery improved the pain during the month of rehab after the surgery!

Evid Based Complement Alternat Med. 2013;2013:694941. doi: 10.1155/2013/694941. Epub 2013 Mar 27.

Efficacy of myofascial trigger point dry needling in the prevention of pain after total knee arthroplasty: a randomized, double-blinded, placebo-controlled trial.

Mayoral O(1), Salvat I, Martín MT, Martín S, Santiago J, Cotarelo J, Rodríguez C.

Author information:  (1)Physical Therapy Unit, Hospital Provincial de Toledo, Cerro de San Servando s/n,  45006 Toledo, Spain.

The aim of this study was to determine whether the dry needling of myofascial trigger points (MTrPs) is superior to placebo in the prevention of pain after total knee arthroplasty. Forty subjects were randomised to a true dry needling group (T) or to a sham group (S). All were examined for MTrPs by an experienced physical therapist 4-5 hours before surgery. Immediately the following anesthesiology and before surgery started, subjects in the T group were dry needled in all previously diagnosed MTrPs, while the S group received no treatment in their MTrPs. Subjects were blinded to group allocation as well as the examiner in presurgical and follow-up examinations performed 1, 3, and 6 months after arthroplasty. Subjects in the T group had less pain after the intervention, with statistically significant differences in the variation rate of the visual analogue scale (VAS) measurements 1 month after intervention and in the need for immediate postsurgery analgesics. Differences were not significant at 3- and 6-month follow-up examinations. In conclusion, a single dry needling treatment of MTrP under anaesthesia reduced pain in the first month after knee arthroplasty, when the pain was the most severe. Results show superiority of dry needling versus placebo. An interesting novel placebo methodology for dry needling, with a real blinding procedure, is presented.

PMCID: PMC3623120 PMID: 23606888  [PubMed]

Dr. Abraham Lieberman, PT, DPT
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