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.

Neck Pain

Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, neck pain ranked 4th highest in terms of disability and 21st in terms of overall burden.

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