The effectiveness of dry needling versus Flurbiprofen LAT patch in the treatment of myofascial pain syndrome of the upper Trapezius muscle

Abstract

Background: Dry needling is known to be effective and efficient in the treatment of myofascial pain syndrome; pragmatically however, patients utilise Flurbiprofen LAT patches as home therapy anticipating similar results. This may not be true and thus, this study aimed to investigate the effectiveness of dry needling versus Flurbiprofen LAT patches in the treatment of myofascial pain syndrome of the upper Trapezius muscle. Methods: This ethics approved, prospective, randomized, single blinded (blinded assessor), comparative clinical trial required sixty participants, randomly (randomisation table) allocated to two groups. After the completion of informed consent participants received treatment over three consultations with a follow up a week later. Baseline and repeated outcome measures included Numerical Pain Rating Scale, Neck Disability Index Questionnaire, Myofascial Diagnostic Scale, Algometer and Cervical Range of Motion device. The data was analysed using ANOVA tests with the p-value set at 0.05. Results: Baseline demographics and outcome measures showed that only age was significantly different between the groups. This difference was controlled for in the statistical analysis. Dry needling resulted in better treatment outcomes than the Flurbiprofen LAT patches in terms of function (cervical range of motion) (right lateral flexion p=0.043) and Myofascial Diagnostic Scale scores (p<0.001), whereas the Algometer measures and remaining cervical ranges of motion improved significantly over time in both groups, but not between the groups. Tthe Flurbiprofen LAT patches fared better in terms of the subjective reporting (Numerical Pain Rating Scale), this was not significant. Conclusion: The interventions were both effective over time, however, the needle group achieved improved functional ability and the Flurbiprofen LAT patches improved the pain outcomes with limited functional ability. Therefore the use of these modalities requires clinical judgement to appropriately administer the treatment option that the patient would best benefit from.