Journal of bodywork and movement therapies
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Randomized Controlled Trial
Comparison of acute effects of superficial and deep dry needling into trigger points of suboccipital and upper trapezius muscles in patients with cervicogenic headache.
The purpose of this study was to compare the acute effects of superficial and deep dry needling into trigger points of suboccipital and upper trapezius muscles in patients with cervicogenic headache. ⋯ The application of dry needling into trigger points of suboccipital and upper trapezius muscles induces significant improvement of headache index, trigger points tenderness, functional rating index and range of motion in patients with cervicogenic headache. Deep dry needling had greater effects on CROM and function.
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In this overview of the myofascial pain literature, we have included several original contributions ranging from a study by Bowen and colleagues of trigger points in horses to the introduction of a new clinical entity of "laryngeal muscle myofascial pain syndrome in dysphonic patients." Minerbi and colleagues described for the first time the referred pain patterns of the longus colli muscle, while Casale and associates studied the spinal modulatory action of dry needling or acupuncture stimulation. Many dry needling articles are included in this overview with several recent outcome studies. ⋯ Several researchers explored specific aspects of dry needling, such as needle placements, whether eliciting a local twitch response is desired, and the role of psychological factors in post-needling soreness. Contributions originated in Australia, Belgium, Brazil, Canada, China, Germany, Greece, India, Israel, Italy, Korea, Portugal, Spain, Switzerland, Turkey, the UK, and the USA.
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Myofascial trigger point (MTrP) injection and trigger point dry needling (TrPDN) are widely accepted therapies for myofascial pain syndrome (MPS). Empirical evidence suggests eliciting a local twitch response (LTR) during needling is essential. ⋯ and Discussion: Several studies show that eliciting a LTR does not correlate with changes in pain and disability, and multiple systematic reviews have failed to conclude whether the LTR is relevant to the outcome of TrPDN. Post needling soreness is consistently reported in studies using repeated in and out needling to elicit LTRs and increases in proportion to the number of needle insertions. In contrast, needle winding without LTRs to MTrPs and connective tissue is well supported in the literature, as it is linked to anti-nociception and factors related to tissue repair and remodeling. Additionally, the positive biochemical changes in the MTrP after needling may simply be a wash out effect related to local vasodilation. While the LTR during TrPDN appears unnecessary for managing myofascial pain and unrelated to many of the positive effects of TrPDN, further investigation is required.
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Myofascial trigger points (MTrP's) are a primary source of pain in patients with musculoskeletal disorders. Nevertheless, they are frequently underdiagnosed. Reliable MTrP palpation is the necessary for their diagnosis and treatment. The few studies that have looked for intra-tester reliability of MTrPs detection in upper body, provide preliminary evidence that MTrP palpation is reliable. Reliability tests for MTrP palpation on the lower limb have not yet been performed. ⋯ This study provides evidence that MTrP palpation is a moderately reliable diagnostic tool in the hip and thigh muscles and can be used in clinical practice and research.
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Randomized Controlled Trial
Effect of ischemic compression for cervicogenic headache and elastic behavior of active trigger point in the sternocleidomastoid muscle using ultrasound imaging.
To investigate the effect of ischemic compression on clinical outcomes of a cervicogenic headache and elastic behavior of myofascial trigger points. ⋯ The improvements in outcome measures suggest that ischemic compression may be effective in subjects with a cervicogenic headache associated with a myofascial trigger point in the sternocleidomastoid muscle. Data suggests that biomechanical properties of MTrP and severity of headache symptoms are not directly linked, and other mechanisms could be more influential in contributing to symptoms.