Inclusion of Trigger Point Dry Needling in a Multimodal Physical Therapy Program for Postoperative Shoulder Pain

The goal of this study was to assess the effects of including 1 session of trigger point dry needling (TrP-DN) into a multimodal physiotherapy treatment on pain and function in postoperative shoulder pain. Twenty patients (5 male; 15 female; age, 58 ± 12 years) with postoperative shoulder pain after either open reduction and internal fixation with Proximal Humeral Internal Locking System plate plate or rotator cuff tear repair were separated at random into 2 groups: physiotherapy group (n = 10) who received best evidence physical therapy interventions and a physical therapy plus TrP-DN group (n = 10) who received the same intervention plus a single session of TrP-DN targeted at active TrPs. The Constant-Murley score was used to determine pain, activities of daily living, range of motion, and strength, which was recorded at baseline and 1 week after by an assessor blinded to group assignment. Analysis of variance revealed that subjects receiving TrP-DN plus physical therapy displayed greater improvement in the Constant-Murley total score (P < .001) and also activities of daily living (P < .001) and strength (P = .019) subscales than those receiving physical therapy alone. Between-group effect sizes were large in favor of the TrP-DN group (0.97 < SMD < 1.45). Both groups experienced similar improvements in pain (P < .001) and range of motion (P < .001).

These results indicate that including a single session of TrP-DN in the first week of a multimodal physical therapy approach may assist with faster increases in function in individuals with postoperative shoulder pain.