title: Immediate and short-term effects of the combination of dry needling and percutaneous TENS on post-needling soreness in patients with chronic myofascial neck pain.
abstract: BACKGROUND
  Dry needling (DN) and percutaneous electrical nerve stimulation (PENS) are widely used techniques in the treatment of myofascial pain.
  
  
  OBJECTIVE
  To investigate the immediate and short-term effects of the combination of DN and PENS compared to DN alone on the upper trapezius muscle.
  
  
  METHODS
  This is a 72-hour follow-up single-blinded randomized controlled trial. Sixty-two volunteer patients with chronic myofascial neck pain with active Myofascial Trigger Points (MTrPs) in the upper trapezius muscle were recruited. Randomization was performed, and 31 patients received DN treatment (DN group) and 31 received DN and PENS (DN+PENS group). The primary outcomes were neck disability index (NDI) and visual analog scale for pain for both post-needling soreness (PNS) and neck pain intensity (NPI). Pressure pain threshold (PPT) and cervical range of motion (CROM) were the secondary outcomes.
  
  
  RESULTS
  We detected between-group differences in NPI and PNS in favor of the DN+PENS group immediately after treatment. No between-group differences in NDI were observed.
  
  
  CONCLUSIONS
  PENS application after dry needling treatment is more effective than dry needling alone for decreasing soreness in the short term and improving neck pain intensity immediately in patients with myofascial chronic neck pain.
authors.affiliation: Department of Physical Therapy, Faculty of Health Science, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain.|Research Group on Movement and Behavioural Science and Study of Pain, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain.
authors.forename: Jose V
authors.initials: JV
authors.lastname: León-Hernández
authors.affiliation: Department of Physical Therapy, Faculty of Medicine, Universidad CEU San Pablo, Madrid, Spain.
authors.forename: Aitor
authors.initials: A
authors.lastname: Martín-Pintado-Zugasti
authors.affiliation: Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain.
authors.forename: Laura G
authors.initials: LG
authors.lastname: Frutos
authors.affiliation: Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain.
authors.forename: Isabel M
authors.initials: IM
authors.lastname: Alguacil-Diego
authors.affiliation: Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain.
authors.forename: Ana I
authors.initials: AI
authors.lastname: de la Llave-Rincón
authors.affiliation: Research Group on Movement and Behavioural Science and Study of Pain, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain.|Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain.|Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain.
authors.forename: Josue
authors.initials: J
authors.lastname: Fernandez-Carnero
mesh_terms: D015670:Acupuncture Therapy; D000328:Adult; D059350:Chronic Pain / Q000503:physiopathology*; D004599:Electric Stimulation Therapy; D006801:Humans; D009209:Myofascial Pain Syndromes / Q000503:physiopathology*; D019547:Neck Pain / Q000503:physiopathology*; D011312:Pressure; D004561:Transcutaneous Electric Nerve Stimulation