The relative effectiveness of a single dry needle insertion compared to multiple fanning dry needle insertions in the treatment of myofasciitis in the cervical and upper thoracic spine

Abstract

Myofascial Pain Syndrome (MPS) is a clinical syndrome of soft tissue pain arising from skeletal muscle. It is manifested by characteristic trigger points (TrPs) in palpable taut bands of muscle fibres with typical referred pain patterns, restricted range of motion and local twitch responses. Treatment of MPS appears to be aimed at disrupting the reverberating neural circuits responsible for the self-perpetuation of the pain-spasm pain cycle. This occurs through inactivating the active TrP through releasing the taut bands with various techniques including massage, ischaemie compression, spray and stretch, ultrasound, hydrocollator moist heat, trigger point injection, dry needling, and TENS. There are many treatments available yet little research substantiating efficiency of one specific therapy over another, with the result that choice of treatment often becomes based on personal preferences rather than clinical evidence. Among many authors, dry needling has been shown to be an effective form of treatment. The therapeutic effect of dry needling relies on the mechanical disruption or direct stimulation of the TrP and that the strongest analgesic effect is achieved when the most painful spot is precisely reached with a fme needle, normally an acupuncture needle. This immediate analgesia produced by needle puncture of a TrP has been termed the