Abstract
Cummings TM, White AR. Needling therapies in the management of myofascial trigger
point pain: a systematic review. Arch Phys Med Rehabil 2001;82:986-92. Objective: To establish whether there is evidence for or against the efficacy of needling as
a treatment approach for myofascial trigger point pain. Data Sources: PubMed, Ovid MEDLINE, Ovid EMBASE, the Cochrane Library, AMED, and CISCOM databases,
searched from inception to July 1999. Study Selection: Randomized, controlled trials in which some form of needling therapy was used to
treat myofascial pain. Data Extraction: Two reviewers independently extracted data concerning trial methods, quality, and
outcomes. Data Synthesis: Twenty-three papers were included. No trials were of sufficient quality or design
to test the efficacy of any needling technique beyond placebo in the treatment of
myofascial pain. Eight of the 10 trials comparing injection of different substances
and all 7 higher quality trials found that the effect was independent of the injected
substance. All 3 trials that compared dry needling with injection found no difference
in effect. Conclusions: Direct needling of myofascial trigger points appears to be an effective treatment,
but the hypothesis that needling therapies have efficacy beyond placebo is neither
supported nor refuted by the evidence from clinical trials. Any effect of these therapies
is likely because of the needle or placebo rather than the injection of either saline
or active drug. Controlled trials are needed to investigate whether needling has an
effect beyond placebo on myofascial trigger point pain. © 2001 by the American Congress of Rehabilitation Medicine and the American Academy
of Physical Medicine and Rehabilitation
Keywords
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Article info
Publication history
Accepted:
September 7,
2000
Received in revised form:
September 7,
2000
Footnotes
☆No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
☆☆Reprint requests to T. Michael Cummings, MB, ChB, 5 Lime Ter, London W7 3HE, UK, e-mail: [email protected]
Identification
Copyright
© 2001 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
