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Needling Interventions for the Management of Musculoskeletal Pain Syndromes—Volume II

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 31 October 2024 | Viewed by 14218

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Prof. Dr. César Fernández De Las Peñas

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Guest Editor

Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Madrid, Spain
Interests: chronic pain; pain neuroscience education, manual therapy; central nervous system sensitization
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Special Issue Information

Dear Colleagues,

It was a pleasure to collaborate as Guest Editor in the Special Issue “Needling Interventions for the Management of Musculoskeletal Pain Syndromes” for the Journal of Clinical Medicine, which was published in 2021 (https://www.mdpi.com/journal/jcm/special_issues/Needling_Intervention_Pain). Fortunately, participation was high, with 13 manuscripts including original research and revisions. The repercussions of musculoskeletal pain syndromes on health-related quality of life are huge. The biopsychosocial model includes the application of different therapeutic strategies targeting different aspects of the pain component for the treatment of chronic pain. The use of needling interventions, in any form, has attracted particular attention in recent decades from clinicians and researchers. Different forms of needling interventions, including dry or wet needling, electrical dry needling, percutaneous nerve electrical stimulation (PENS), or neuromodulation, can be used for managing chronic pain.

Our goal now is to launch a second edition of the Special Issue, titled “Novel Research in Needling Interventions for Chronic Pain”. Numerous topics remain to be investigated, including potential underlying mechanisms, long-term effects of the interventions, theoretical aspects of needling interventions, and clinical guideline practice. In addition, knowledge of the effects of combining needling interventions with manual therapy, exercise or pain neuroscience education may be useful in the management of chronic pain. All these aspects related to needling interventions are welcome.

Any research group investigating the effects of needling interventions for the management of chronic pain is encouraged in this new volume of this Special Issue. We invite researchers to contribute with original articles, narrative reviews, systematic reviews, meta-analyses, scoping reviews, or potential hypotheses of potential mechanisms.

Prof. Dr. César Fernández De Las Peñas
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

dry needling
percutaneous nerve electrical stimulation
neuromodulation
chronic pain
physical therapy
treatment

Published Papers (4 papers)

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11 pages, 849 KiB

Open AccessArticle

Effect of Ultrasound-Guided Percutaneous Neuromodulation of Sciatic Nerve on Hip Muscle Strength in Chronic Low Back Pain Sufferers: A Pilot Study

by Roberto San-Emeterio-Iglesias, Blanca De-la-Cruz-Torres, Carlos Romero-Morales and Francisco Minaya-Muñoz

J. Clin. Med. 2022, 11(22), 6672; https://doi.org/10.3390/jcm11226672 - 10 Nov 2022

Cited by 1 | Viewed by 1989

Abstract

Background: Limited hip internal rotation range of motion (IR-ROM) and hip abductor weakness are recognized in low back pain (LBP) sufferers. The main aim was to investigate the effect of a ultrasound (US)-guided percutaneous neuromodulation (PNM) technique on hip strength in people with LBP. A second purpose was to discover whether the location along the sciatic nerve, where percutaneous neuromodulation was applied, could influence the change of strength response in these patients. Methods: Sixty LBP sufferers were recruited and divided randomly into three groups. All participants received an isolated percutaneous electrical stimulation at one of three different locations of the sciatic nerve pathway (proximal, middle, and distal), depending on the assigned group. Pain intensity, hip passive IR-ROM, hip muscle strength, and the Oswestry disability index (ODI) were analyzed. All variables were calculated before the intervention and one week after the intervention. Results: All interventions significantly decreased pain intensity and improved the IR-ROMs, strength, and functionality after one week (p = 0.001). However, between-group (treatment x time) differences were reported for flexion strength in the non-intervention limb (p = 0.029) and ODI (p = 0.021), although the effect size was small (Eta² = 0.1) in both cases. Conclusions: The application of an isolated intervention of the US-guided PNM technique may be a useful therapeutic tool to increase the hip muscle strength in patients with chronic LBP. Full article

(This article belongs to the Special Issue Needling Interventions for the Management of Musculoskeletal Pain Syndromes—Volume II)

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15 pages, 3769 KiB

Open AccessArticle

Immediate Effects of Dry Needling on Central Pain Processing and Skin Conductance in Patients with Chronic Nonspecific Neck Pain: A Randomized Controlled Trial

by Marcos José Navarro-Santana, Juan Antonio Valera-Calero, Guillermo Romanos-Castillo, Victor C. Hernández-González, César Fernández-de-las-Peñas, Ibai López-de-Uralde-Villanueva and Gustavo Plaza-Manzano

J. Clin. Med. 2022, 11(22), 6616; https://doi.org/10.3390/jcm11226616 - 08 Nov 2022

Cited by 1 | Viewed by 2246

Abstract

Although current evidence supports the use of dry needling for improving some clinical outcomes in people with neck pain, no previous research explored the effects of dry needling on the central processing of pain and autonomic nervous system in this population. Therefore, this clinical trial aimed to compare the effects of real and sham dry needling on autonomic nervous system function, pain processing as well as clinical and psychological variables in patients with chronic nonspecific neck pain. A double-blinded randomized clinical trial including 60 patients with neck pain was conducted. Patients were randomized to the real needling (n = 30) or sham needling (n = 30) group. Skin conductance (SC), pressure pain thresholds (PPTs), temporal summation (TS), conditioned pain modulation (CPM) as well as pain intensity, related-disability, catastrophism, and kinesiophobia levels were assessed by an assessor blinded to the allocation intervention. The results did not find significant group * time interactions for most outcomes, except for the global percentage of change of SC values (mean: F = 35.90, p < 0.001,

η_{p}^{2}

= 0.459; minimum: F = 33.99, p = 0.839,

η_{p}^{2}

= 0.371; maximum: F = 24.71, p < 0.001,

η_{p}^{2}

= 0.037) and PPTs at C5-C6 joint in the same side of needling (F = 9.982; p = 0.003; = 0.147), in favor of the dry needling group. Although the proportion of subjects experiencing moderate to large self-perceived improvement after the intervention was significantly higher (X2 = 8.297; p = 0.004) within the dry needling group (n = 18, 60%) than in the sham needling group (n = 7, 23.3%), both groups experienced similar improvements in clinical and psychological variables. Our results suggested that dry needling applied to patients with chronic nonspecific neck pain produced an immediate decrease in mechanical hyperalgesia at local sites and produced an increase in skin conductance as compared with sham needling. No changes in central pain processing were observed. A single session of sham or real dry needling was similarly effective for decreasing related disability, pain intensity, catastrophism, and kinesiophobia levels. Further studies are needed to better understand the clinical implications of autonomic nervous system activation on central sensitization and pain processing in the long-term after the application of dry needling. Full article

(This article belongs to the Special Issue Needling Interventions for the Management of Musculoskeletal Pain Syndromes—Volume II)

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12 pages, 573 KiB

Open AccessArticle

Short-Term Effects of Dry Needling with a Standard Exercise Program on Pain and Quality of Life in Patients with Chronic Mechanical Neck Pain

by Muhannad Almushahhim, Shibili Nuhmani, Royes Joseph, Wafa Hashem Al Muslem and Turki Abualait

J. Clin. Med. 2022, 11(20), 6167; https://doi.org/10.3390/jcm11206167 - 19 Oct 2022

Cited by 2 | Viewed by 2188

Abstract

Background: This study aimed to determine the short-term effects of dry needling (DN) combined with a standard exercise program on pain and quality of life in patients with chronic mechanical neck pain (CMNP). Methods: Thirty-one patients with CMNP were randomly allocated to the experimental and control groups. The experimental group received DN and underwent a standard exercise program (one DN session and six exercise sessions) for two weeks, whereas the control group underwent the same exercise program alone for two weeks. The participants’ scores in the Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI), Short Form-36 Quality of Life Scale (SF-36 QOLS), and Beck Depression Inventory (BDI) before and after the intervention were assessed. Results: The control and experimental groups’ post-test NDI, NPRS, SF-36 QOLS, and BDI scores significantly differed from their baseline scores (p ≤ 0.05). The between-group comparison of the post-test scores using Wilcoxon rank-sum test revealed no significant differences between the NDI, NPRS, BDI, and SF-36 QOLS scores of both groups (p ≥ 0.05). Conclusions: One session of trigger point DN (TrP-DN) with exercise and exercise alone showed the same pain and quality-of-life outcomes after a two-week intervention. We did not recognise TrP-DN as an efficient intervention, not because we obtained evidence that it is ineffective, but because there were inadequate high-quality studies on the subject and unavailable data on the minimum quantity of injections required for better DN outcomes in CMNP patients. Full article

(This article belongs to the Special Issue Needling Interventions for the Management of Musculoskeletal Pain Syndromes—Volume II)

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30 pages, 935 KiB

Open AccessSystematic Review

Clinical Effectiveness of Dry Needling in Patients with Musculoskeletal Pain—An Umbrella Review

by Marjolein Chys, Kayleigh De Meulemeester, Indra De Greef, Carlos Murillo, Wouter Kindt, Yassir Kouzouz, Bavo Lescroart and Barbara Cagnie

J. Clin. Med. 2023, 12(3), 1205; https://doi.org/10.3390/jcm12031205 - 02 Feb 2023

Cited by 7 | Viewed by 6809

Abstract

The number of systematic reviews (SR) summarizing the literature regarding the clinical effects of Dry Needling (DN) has increased rapidly. Yet, rigorous evidence about the clinical effectiveness of this technique is still lacking. The aim of this umbrella review is to summarize the evidence about the clinical effects of trigger point DN on musculoskeletal disorders across all body regions. PubMed, Web of Science and Embase were searched to identify SRs examining the effect of DN (as a stand-alone intervention or combined with another treatment modality) compared to sham/no intervention or a physical therapy (PT) intervention with at least one clinical outcome in the domain of pain or physical functioning. Risk of bias (RoB) was assessed with the AMSTAR-2 tool. Quantification of the overlap in primary studies was calculated using the corrected covered area (CCA). The electronic search yielded 2286 results, of which 36 SRs were included in this review. Overall, DN is superior to sham/no intervention and equally effective to other interventions for pain reduction at short-term regardless of the body region. Some SRs favored wet needling (WN) over DN for short-term pain reductions. Results on physical functioning outcomes were contradictory across body regions. Limited data is available for mid- and long-term effects. DN has a short-term analgesic effect in all body regions and may be of additional value to the interventions that are used to date in clinical practice. Several studies have shown an additional treatment effect when combining DN to physiotherapeutic interventions compared to these interventions in isolation. There is a substantial need for the standardization of DN protocols to address the problem of heterogeneity and to strengthen the current evidence. Full article

(This article belongs to the Special Issue Needling Interventions for the Management of Musculoskeletal Pain Syndromes—Volume II)

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