title: Trigger point dry needling versus strain-counterstrain technique for upper trapezius myofascial trigger points: a randomised controlled trial.
abstract: BACKGROUND
  Treatment of active myofascial trigger points includes both invasive and non-invasive techniques.
  
  
  OBJECTIVE
  To compare the effects of upper trapezius trigger point dry needling (DN) and strain-counterstrain (SCS) techniques versus sham SCS.
  
  
  METHODS
  Randomised controlled trial.
  
  
  METHODS
  34 study subjects with active trigger points were randomly assigned to one of three treatment groups, and received either three sessions of DN (n=12), six sessions of SCS (n=10), or sham SCS (n=12) over a 3-week period. Subjective pain response and subjects' own ratings of perceived disability were measured.
  
  
  RESULTS
  The analysis of variance mixed model showed a significant time effect for pain (p<0.001), elicited pain (p<0.001), pain pressure threshold (p<0.01), and neck disability index (p=0.016). Pain at rest decreased in all groups, as follows: DN 18.5 mm (95% CI 4.3 to 32.7 mm); SCS 28.3 mm (95% CI 12.4 to 44.1 mm); sham SCS 21.9 mm (95% CI 3.5 to 40.1 mm). Reductions in disability score (points) were significant in the SCS group (5.5, 95% CI 1.6 to 9.4) but not in the DN (1.4, 95% CI -4.9 to 2.1) or sham SCS (1.8, 95% CI -6.4 to 2.7) groups. There was no significant group×time interaction effect for any variables studied.
  
  
  CONCLUSIONS
  There were no differences between the sham SCS, SCS, and DN groups in any of the outcome measures. DN relieved pain after fewer sessions than SCS and sham SCS, and thus may be a more efficient technique. Future studies should include a larger sample size.
  
  
  BACKGROUND
  NCT01290653.
authors.affiliation: Department of Physiotherapy, Universidad CEU-Cardenal Herrera, Moncada, Valencia, Spain.
authors.forename: E
authors.identifier: http://orcid.org/0000-0002-9172-042X
authors.initials: E
authors.lastname: Segura-Ortí
authors.affiliation: Department of Physiotherapy, Universidad CEU-Cardenal Herrera, Moncada, Valencia, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Prades-Vergara
authors.affiliation: Department of Physiotherapy, Universidad CEU-Cardenal Herrera, Moncada, Valencia, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Manzaneda-Piña
authors.affiliation: Department of Physiotherapy, Universidad CEU-Cardenal Herrera, Moncada, Valencia, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Valero-Martínez
authors.affiliation: Outpatient Physical Therapy Department, Robert Packer Hospital, Sayre, PA, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Polo-Traverso
mesh_terms: D015670:Acupuncture Therapy / Q000295:instrumentation / Q000379:methods*; D000328:Adult; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D019547:Neck Pain / Q000628:therapy*; D009339:Needles; D064171:Superficial Back Muscles; D061028:Trigger Points
keywords: ACUPUNCTURE; MYOFASCIAL PAIN