Comparison of Efficacy of Dry Needling and Kinesio-taping
Condition: Myofascial Pain Syndromes
MeSH terms: Myofascial Pain Syndromes; Fibromyalgia
Study type: Interventional

Summary: 
      The aim of the current study was to investigate the effects of KT and DN combined with
      exercise on pain, range of motion (ROM), and upper extremity function in patients with common
      shoulder disorders.
    

Detailed description: 
      Shoulder pain is a common musculoskeletal problem seen in working population. The main
      contributor to nontraumatic upper-limb pain, in which chronicity and recurrence of symptoms
      are common. A common cause of muscle pain is myofascial pain caused by myofascial trigger
      points (MTrPs). Travel and Simons have described trigger points as 'a tender point on
      palpation characterized by referring pain, motor dysfunction and autonomic symptoms and
      usually located in the taut band or the fascia of the muscle. MTrPs in the shoulder muscles
      produce symptoms similar to those of other shoulder pain syndromes, including pain at rest
      and with movement, sleep disturbances and pain provocation during impingement tests. MTrPs
      are classified into active and latent trigger points. An active MTrP causes a clinical pain
      complaint. It is always tender, prevents full lengthening of the muscle, weakens the muscle,
      refers a patient-recognized pain on compression, mediates a local twitch response of muscle
      fibers when adequately stimulated and, when compressed within the patient's pain tolerance,
      produces referred motor phenomena and often autonomic phenomena, generally in its pain
      reference zone, and causes tenderness in the pain reference zone. A latent MTrP is clinically
      quiescent with respect to spontaneous pain; it is painful only when palpated. A latent MTrP
      may have all the other clinical characteristics of an active MTrP and always has a taut band
      that increases muscle tension and restricts range of motion. An alternative approach to the
      management of persons with shoulder problems consists of a treatment aimed at inactivating
      MTrPs and eliminating factors that perpetuate them. Manual techniques (such as compression on
      the trigger point or other massage techniques), cooling the skin with ethyl chloride spray
      and stretch and trigger point needling can inactivate MTrPs. MTrP inactivation may be
      combined with active exercises, postural correction, extracorporeal shock wave therapy,
      kinesio taping and relaxation if and when appropriate. Kinesio taping (KT) and dry needling
      (DN) are two common applications being used in treatment of acute and chronic musculoskeletal
      problems in recent years. Several therapies have been proposed for MTrPs, including KT, a
      relatively new method that has become widely used as a therapeutic tool in a variety of
      prevention and rehabilitation protocols. KT is an elastic cotton adhesive tape which is
      latex-free and can be used on any joint or muscle. Te exact mechanism by which KT functions
      remain unknown, though it is thought that its effectiveness may be mediated by cutaneous
      mechanoreceptors which would provide sensorimotor and proprioceptive feedback, and/or by
      mechanical restraint and inhibitory and excitatory nociceptive stimuli [16]. Various groups
      have shown that the use of KT can be beneficial, for example, by decreasing pain or by
      increasing range of motion (ROM) in shoulder pathologies. Among the non-pharmacological
      options, DN, despite the controversy, is currently considered one of the most effective
      interventions for the direct inactivation of MTrPs and is gaining attention for the treatment
      of MTrPs in musculoskeletal pain by targeting trigger points and non- trigger point
      structures. It is a skilled intervention that uses a thin filiform needle to penetrate the
      skin and stimulate underlying trigger points, muscular and connective tissues without the use
      of injectate. A systematic review with meta-analysis reported that DN, compared with
      sham/placebo, can decrease pain immediately after treatment and in four weeks among patients
      with upper quarter myofascial pain syndrome. Another systematic review with metaanalysis
      reported that DN can be recommended to relieve MTrP pain of neck and shoulders in short and
      medium terms, but wet needling is more effective than DN in reducing MTrP pain in neck and
      shoulders in medium term.
    

Intervention name(s): Rehabilitation
Intervention type(s): Other
Intervention description(s): Training
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: shoulder pain; myofascial trigger point; dry needling; kinesio tape; exercise