Therapeutic efficacy of dry-needling techniques and spinal adjustive procedures in the management of myofascial trigger point syndromes

Abstract

Musculoskeletal disorders are probably the most neglected conditions in modem medical teachings (Travell and Simons, 1983) It is the aim of this randomised uncontrolled comparative study to investigate the efficacy of a combination of chiropractic adjustment procedures and myofascial trigger point therapy in the form of dry-needling techniques, as opposed to myofascial trigger point therapy alone. The rationale being to determine an appropriate approach to the treatment of MyofasciaIPain and Dysfunction Syndromes. The population sample consisted of thirty two individuals selected from patients presenting at the Technikon Natal Chiropractic Clinic with cervical and thoracic myofasciitis. These patients were randomly assigned to two groups consisting of sixteen patients each. The group receiving dry-needling techniques only was considered experimental Group DN, and the group receiving a combination of chiropractic treatment and dry-needling techniques, the experimental Group c. All patients were given specific stretch exercises for the affected muscle groups and received patient education and lifestyle advice aimed at preventing re-occurrence of their condition. Clinical criteria governing the selection of patients for the study were based on those set out by TraveIl and Simons (1983: 13-17) for patients suffering from Myofascial Pain and Dysfunction Syndrome. In all patients, trigger points were active and were localised to one or more of the following muscle groups: the sternocleidomastoid, levator scapulae, trapezius, rhomboid, supraspinatus, infraspinatus, deltoid and/or scalene muscles. Patients were treated until asymptomatic or for a maximum of nine treatments (whichever one came first). Treatments were given over a three week period and thereafter a follow-up consultation approximately one month later. Subjective data prior to each consultation was collected using the Numerical Rating Scale, the Pain Disability Index, the CCC Neck Disability Index, the Short-Form Magill Pain Questionnaire and Symptom Diagrams.