1. 2017;20;37-52Effects of Dry Needling on Spinal Mobility and Trigger Points in Patients with Fibromyalgia Syndrome
   Randomized Trial
   Adelaida Maria Castro-Sanchez, PhD, Hector Garcia-Lopez, PT, Guillermo A. Mataran-Penarrocha, MD, Manuel Fernandez-Sanchez, PhD, Cayetano Fernandez-Sola, PhD, Jose Granero-Molina, PhD, and Maria Encarnacion Aguilar-Ferrandiz, PhD.

BACKGROUND: The etiology of fibromyalgia syndrome (FMS) is inconclusive, but central mechanisms are well accepted for this pain condition. Myofascial pain syndrome (MPS) is one of the most common musculoskeletal pain diseases and is characterized by myofascial trigger points (MTrPs). It has been suggest that MTrPs have an important factor in the genesis of FMS.

OBJECTIVE: The purpose of the current randomized clinical trial was to compare the effectiveness of dry needling versus cross tape on spinal mobility and MTrPs in spinal muscles in patients with FMS.

STUDY DESIGN: A single-blind randomized controlled trial was conducted on patients with FMS.

SETTING: Clinical setting.

METHODS: Sixty-four patients with FMS were randomly assigned to an experimental group receiving dry needling therapy or to a control group for cross tape therapy in the MTrPs in the latissimus dorsi, iliocostalis, multifidus, and quadratus lumbourum muscles. Spinal mobility measures and MTrPs algometry were recorded at baseline and after 5 weeks of treatment.

RESULTS: The repeated measures analysis of variance (ANOVA) demonstrated that significant differences between groups were achieved for the MTrPs in latissimus dorsi muscle (right axillary portion: F = 9.80, P = 0.003); multifidus muscle (right L2 level: F = 11.80, P = 0.001); quadratus lumborum (right lateral superficial upper: F = 6.67, P = 0.012; and right lateral superficial lower: F = 5.38, P = 0.024). In addition, the ANOVA repeated measures test showed significant differences between groups for the segmental amplitude thoracic spine in the standing erect position (F = 7.33, P = 0.009), and segmental amplitude of lumbar spine (F = 11.60, P = 0.001) in the sitting erect position.

LIMITATIONS: The outcomes were not collected from a long-term follow-up period. Dry needling therapy or cross tape were used alone when in reality physical therapists usually treat patients with FMS using a multi-modal approach. A non-treatment control group was not included.

CONCLUSIONS: This study has demonstrated that dry needling therapy reduces myofacial trigger points algometry on thoracic and lumbar muscles. Dry needling and cross tape approaches reported a similar effect size for spinal mobility measures in patients with FMS.

Key words: Fibromyalgia, trigger points, physical therapy modalities, musculoskeletal
equilibrium, myofascial pain syndromes