I was happy to note that yet another systematic review, this time from a Chinese research team, found dry needling to be an evidence-based intervention for the treatment of neck and shoulder pain.
Effectiveness of Dry Needling for Myofascial Trigger Points Associated with Neck and Shoulder Pain: A Systematic Review and Meta-analysis.
Conclusion: Dry needling can be recommended to relieve MTrP pain of neck and shoulders in short and medium terms, but wet needling is more effective than dry needling in reducing MTrP pain in neck and shoulders in medium term (9 days to 28 days).
We have not begun to fully understand the mechanisms by which dry needling affects soft tissue physiology. The reasons are numerous, but essentially we do not yet understand the nature of what causes skeletal muscle and other soft tissue structures to develop points of clinically relevant symptomology. This has been a point of relevant criticism and must remain so until the answers emerge.
However, the lack of answers is not a rationale to question the use of this intervention in the clinical setting, especially given the evidence for its efficacy, cost-effectiveness and safety.
A famous example, the story of Aspirin, springs to mind and has a number of similarities to the story of dry needling of trigger points. Here are some highlights:
- Both interventions were ‘discovered’ many thousands of years ago, by the Egyptians and Chinese, respectively.
- Their medical applications were discovered well before the mechanisms of action were understood.
- The side-effects of these interventions are negligible in comparison their health benefits.