A recent systematic review by Kietrys et al (2013), provides us with level 1A evidence in support of what we as clinicians using Dry Needling for Myofascial Pain Syndrome (MPS) have known for a long time....it works!
In the meta-analysis, twelve quality RCT’s were selected which met the following inclusion criteria: human subjects, dry needling intervention group, and MPS involving the upper quarter. The methodological quality scores ranged from 23 to 40 points, with a mean of 34 points (scale range 0-48, best possible score-48) using the the MacDermid Quality Checklist.
The authors concluded:
Based on the best current available evidence, we recommend (Grade A) Dry Needling, compared to sham or placebo, for decreasing pain (immediately after treatment and at 4 weeks) in patients with upper quarter MPS. Due to the small number of high quality RCTs published to date, additional well-designed studies are needed to inform future evolution of this recommendation.
A fews things to note here. RCT’s were selected which involved the treatment of MPS specifically, a condition which is clinically more likely to respond to Dry Needling. When treating trigger points associated with MPS we are more likely to see a significant treatment benefit in the needling group vs sham, hence it is easier to show efficacy. It should be noted this may not be the case for all pain conditions for which needling techniques are effective such as migraine where point location may be less relevant.
So based on this study we needlers should be be more confident that if we select our patients appropriately we will get good clinical results with an evidence based treatment technique.