title: Effects of dry needling to the symptomatic versus control shoulder in patients with unilateral subacromial pain syndrome.
abstract: BACKGROUND
  Initial reports suggest that treating myofascial trigger points in the infraspinatus with dry needling may be effective in treating patients with shoulder pain. However, to date, high quality clinical trials and thorough knowledge of the physiologic mechanisms involved is lacking.
  
  
  OBJECTIVE
  To examine the effect of dry needling to the infraspinatus muscle on muscle function, nociceptive sensitivity, and shoulder range of motion (ROM) in the symptomatic and asymptomatic shoulders of individuals with unilateral subacromial pain syndrome.
  
  
  METHODS
  Within-subjects controlled trial.
  
  
  METHODS
  Fifty-seven volunteers with unilateral subacromial pain syndrome underwent one session of dry needling to bilateral infraspinatus muscles. Outcome assessments, including ultrasonic measures of infraspinatus muscle thickness, pressure algometry, shoulder internal rotation and horizontal adduction ROM, and questionnaires regarding pain and related disability were taken at baseline, immediately after dry needling, and 3-4 days later.
  
  
  RESULTS
  Participants experienced statistically significant and clinically relevant changes in all self-report measures. Pressure pain threshold and ROM significantly increased 3-4 days, but not immediately after dry needling only in the symptomatic shoulder [Pressure pain threshold: 5.1 (2.2, 8.0) N/cm2, internal rotation ROM: 9.6 (5.0, 14.1) degrees, horizontal adduction ROM: 5.9 (2.5, 9.4) degrees]. No significant changes occurred in resting or contracted infraspinatus muscle thickness in either shoulder.
  
  
  CONCLUSIONS
  This study found changes in shoulder ROM and pain sensitivity, but not in muscle function, after dry needling to the infraspinatus muscle in participants with unilateral subacromial pain syndrome. These changes generally occurred 3-4 days after dry needling and only in the symptomatic shoulders.
authors: U.S. Army-Baylor University Doctoral Program in Physical Therapy, San Antonio, TX, USA; South College Doctor of Physical Therapy Program, Knoxville, TN, USA. Electronic address: shanekoppenhaver@mac.com.
authors: Shane
authors: S
authors: Koppenhaver
authors: U.S. Army-Baylor University Doctoral Program in Physical Therapy, San Antonio, TX, USA.
authors: Robin
authors: R
authors: Embry
authors: U.S. Army-Baylor University Doctoral Program in Physical Therapy, San Antonio, TX, USA.
authors: John
authors: J
authors: Ciccarello
authors: U.S. Army-Baylor University Doctoral Program in Physical Therapy, San Antonio, TX, USA.
authors: Justin
authors: J
authors: Waltrip
authors: U.S. Army-Baylor University Doctoral Program in Physical Therapy, San Antonio, TX, USA.
authors: Rachel
authors: R
authors: Pike
authors: South College Doctor of Physical Therapy Program, Knoxville, TN, USA.
authors: Michael
authors: M
authors: Walker
authors: Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Alcorcón, Madrid, Spain.
authors: Cesar
authors: C
authors: Fernández-de-Las-Peñas
authors: U.S. Army-Baylor University Doctoral Program in Physical Therapy, San Antonio, TX, USA.
authors: Theodore
authors: T
authors: Croy
authors: South College Doctor of Physical Therapy Program, Knoxville, TN, USA.
authors: Timothy
authors: T
authors: Flynn
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009209:Myofascial Pain Syndromes / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D020069:Shoulder Pain / Q000534:rehabilitation*; D061028:Trigger Points
keywords: Dry needling; Muscle function; Shoulder pain; Trigger point; Ultrasound imaging