Comparison of dry needling with physical modalities for myofascial trigger point of patients with neck pain: A systematic review and meta-analysis.

OBJECTIVE

Myofascial pain syndrome (MPS) is a chronic musculoskeletal condition characterized by activation of myofascial trigger points (MTrPs). This systematic review compared the effects of dry needling (DN) and physical modalities on pain and function in patients with MPS.

METHODS

PubMed, Embase, Scopus, and Cochrane Library were searched for randomized controlled trials (RCTs) up to September 2023 comparing DN with physical modalities for MTrPs-induced neck pain. Risk of bias was assessed using the Cochrane tool, and meta-analyses were performed with a random-effects model. Outcomes included visual analog scale (VAS), pressure pain threshold (PPT), and neck disability index (NDI), expressed as pooled mean difference (MD) with 95 % confidence intervals (CI). Evidence quality was graded using the GRADE approach.

RESULTS

Eight RCTs met inclusion criteria. All studies showed high risk of bias due to lack of participant blinding, resulting in moderate-to-low GRADE ratings. DN and physical modalities showed no statistically or clinically significant differences in pain (VAS: MD = -0.13 cm, 95 % CI: 0.35 to 0.09, P = 0.24), PPT (MD = 0.04 kgf, 95 % CI: 0.08 to 0.16, P = 0.48), or function (NDI: MD = 0.00, 95 % CI: 0.61 to 0.60, P = 0.99). Heterogeneity was low, and no treatment-related adverse events were reported.

CONCLUSIONS

DN and physical modalities appear similarly effective for MPS, but high-quality RCTs are needed to strengthen the evidence.