Researchers propose a study to determine whether adding dry needling to a physiotherapy regime will reduce chronic shoulder pain and discomfort.
Chronic shoulder pain is an extremely common problem. Pain in this area of the upper limb has a high recurrence and the symptoms can last from anywhere from six to 12 months for approximately half of the patients. The annual prevalence of shoulder pain is 20 to 50%. There is no set definition for chronic shoulder pain.  Most times, it is referred to as nonspecific shoulder pain and is commonly localized in the upper arm, forearm, and shoulder region. Shoulder impingement syndrome, otherwise known as thrower’s shoulder, is thought to be the primary cause of chronic shoulder pain, although it has not been conclusively demonstrated.
The presence of trigger points, also known as “muscle knots” is a common condition for people who have chronic shoulder pain. Many confuse the presence of these muscle knots with the chronic shoulder pain. The treatment for shoulder pain is not clearly established, but it may involve physical therapy, corticosteroid injections, dry needling (or acupuncture), stretching, and mobilization techniques among many others. There is not yet an established, standard, accepted protocol for treatment, leaving much to the discretion of the practitioner. A combination of exercise therapy with manual therapy, such as dry needling, has shown some promising results for other chronic limb pain. However, there is no clear protocol on this combination therapy for chronic shoulder pain and its effectiveness for treatment.
Researchers recently published a study protocol in the journal of BMC Musculoskeletal Disorders. The study will address the issue of creating an effective inclusion of a dry needling procedure with the combination of manual and therapeutic exercise treatment for chronic shoulder pain. Dry needling, which uses acupuncture techniques, is used for muscle pain therapy. For the study, the researchers propose including 36patients between 18 and 65 years have chronic shoulder pain with no known origin that has persisted for at least three months.
The main data from this study will be gathered using the intensity of shoulder pain. This will be measured by a Visual Analogue Scale (VAS) which marks the intensity of patient’s pain. Other secondary measurements include the disabilities of the arm, shoulder, and hand, pressure pain threshold, shoulder range of motion, and strength in shoulder movements.
The main purpose of this study is to determine whether adding dry needling in a manual physical therapy protocol has a greater effect at reducing pain and disability in patients with unspecified chronic shoulder pain. This will aid physicians to effectively set up a protocol that combines the use of DN, manual physiotherapy and a therapeutic exercise program with a follow-up. This is a start to establishing new avenues of therapy for chronic shoulder pain that has no known source.
Written by Ingrid Qemo, BSc
Reference:
Tejera-Falcon, E., Toledo-Martel, N., Sosa-Medina, F.M., Santana-Gonzalez, F., Quintana-de la Fe, M., Gallego-Izquierdo, T., and Pecos-Martin, D. 2017. “Dry needling in a manual physiotherapy and therapeutic exercise protocol for patients with chronic mechanical shoulder pain of unspecific origin: a protocol for a randomized control trial”. BMC Musculoskeletal Disorders 18:400. DOI 10.1186/s12891-017-1746-3
