Evaluation of the Efficacy and Neurological Effects of Dry Needling in the Treatment of Myofascial Pain Syndrome

NCT ID: NCT02179320

Last Updated: 2018-05-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-02-28

Study Completion Date

2015-02-28

Brief Summary

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AIM OF INVESTIGATION: To evaluate in a prospective, randomized, sham-controlled study the pattern of analgesic efficacy of trigger point dry needling in Myofascial Pain Syndrome (MPS) patients.

Detailed Description

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This study will be performed in patients with shoulder pain due to excess of nociception associated with chronic Myofascial Pain Syndrome in asymmetrical unilateral trapezius muscle trigger points.

Patients will be randomly assigned to two treatment arms: Active (A) (n=20) and Sham (S) (n=21). Group A will receive actual treatment with trigger point dry needling. Group S will receive a sham treatment, with the needle inserted superficially in the skin, without reaching the muscle underneath it.

The duration and pain elicited during active and sham dry needling will be controlled for. Patients will be evaluated one week before needling (D-7), on the day of dry needling (D0) and seven days after the procedure (D+7).

Patients will fill out the Brazilian version of the Douleur Neuropathique 4, Beck Depression Inventory, Brief Pain Inventory (BPI), McGill Pain Questionnaire-SF (SFMPQ), Hospital Anxiety and Depression Scale and Global Impression of Change, and also a 14-day Carnet to more accurately evaluate their daily pain before and after the treatment.

For the evaluation of neurologic changes, we will evaluate local hyperalgesia, tactile, mechanical, static and thermal sensitivity with thermal quantitative sensorial testing (TQS), and also mapping of the painful area, before and after treatment in both D0 and D+7.

Conditions

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Myofascial Pain Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Dry needling

Dry needling for myofascial pain syndrome, in the trapezius muscle.

Group Type ACTIVE_COMPARATOR

Dry needling

Intervention Type PROCEDURE

Dry needling of the painful muscles, with an acupuncture needle 0,25 x 40mm

acupuncture needle 0,25 x 40mm

Intervention Type DEVICE

Sham needling

Superficial dry needling in the trapezius muscle

Group Type SHAM_COMPARATOR

Dry needling

Intervention Type PROCEDURE

Dry needling of the painful muscles, with an acupuncture needle 0,25 x 40mm

Interventions

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Dry needling

Dry needling of the painful muscles, with an acupuncture needle 0,25 x 40mm

Intervention Type PROCEDURE

acupuncture needle 0,25 x 40mm

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Assymetric shoulder pain (VAS on painful side : VAS on non painful side \> 2:1)
* Pain due to unilateral Myofascial Pain Syndrome of the trapezius muscle.
* Chronic pain, with duration of at least 3 months and VAS \> 40/100
* Patients with pain at least 4 days in a week
* Patients without neurological pain, as in DN4 score less than 4
* Age over 18 years
* Patients with stable drug treatment over at least 15 days, without any acute pharmacological changes during the study
* Patients who read, understood and signed the Free and Clarified Consent Term

Exclusion Criteria

* Patients with major depression, according to DSM-IV criteria
* History of bipolar mood disorder, panic syndrome or psychosis
* Intermittent pain history
* Refusal to sing the Consent Term
* Patients not able to attend all the follow-ups
* Patients with another pain syndrome in shoulders
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fundação de Amparo à Pesquisa do Estado de São Paulo

OTHER_GOV

Sponsor Role collaborator

University of Sao Paulo General Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Daniel C Andrade, M.D., P.h.D.

Role: STUDY_CHAIR

University of Sao Paulo

Juliana T Toma, M.D.

Role: PRINCIPAL_INVESTIGATOR

University of Sao Paulo

Irina Raicher, M.D.

Role: PRINCIPAL_INVESTIGATOR

University of Sao Paulo

Manoel J Teixeira, M.D., P.h.D.

Role: STUDY_DIRECTOR

University of Sao Paulo

Helena H Kaziyama, M.D.

Role: PRINCIPAL_INVESTIGATOR

University of Sao Paulo

Locations

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Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

São Paulo, São Paulo, Brazil

Site Status

Countries

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Brazil

References

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Yap EC. Myofascial pain--an overview. Ann Acad Med Singap. 2007 Jan;36(1):43-8.

Reference Type BACKGROUND
PMID: 17285185 (View on PubMed)

Gerwin RD. Classification, epidemiology, and natural history of myofascial pain syndrome. Curr Pain Headache Rep. 2001 Oct;5(5):412-20. doi: 10.1007/s11916-001-0052-8.

Reference Type BACKGROUND
PMID: 11560806 (View on PubMed)

Ga H, Choi JH, Park CH, Yoon HJ. Dry needling of trigger points with and without paraspinal needling in myofascial pain syndromes in elderly patients. J Altern Complement Med. 2007 Jul-Aug;13(6):617-24. doi: 10.1089/acm.2006.6371.

Reference Type BACKGROUND
PMID: 17718644 (View on PubMed)

Cummings TM, White AR. Needling therapies in the management of myofascial trigger point pain: a systematic review. Arch Phys Med Rehabil. 2001 Jul;82(7):986-92. doi: 10.1053/apmr.2001.24023.

Reference Type BACKGROUND
PMID: 11441390 (View on PubMed)

McCain GA, Bell DA, Mai FM, Halliday PD. A controlled study of the effects of a supervised cardiovascular fitness training program on the manifestations of primary fibromyalgia. Arthritis Rheum. 1988 Sep;31(9):1135-41. doi: 10.1002/art.1780310908.

Reference Type BACKGROUND
PMID: 3048273 (View on PubMed)

Giamberardino MA. Referred muscle pain/hyperalgesia and central sensitisation. J Rehabil Med. 2003 May;(41 Suppl):85-8. doi: 10.1080/16501960310010205.

Reference Type BACKGROUND
PMID: 12817663 (View on PubMed)

Ge HY, Fernandez-de-las-Penas C, Arendt-Nielsen L. Sympathetic facilitation of hyperalgesia evoked from myofascial tender and trigger points in patients with unilateral shoulder pain. Clin Neurophysiol. 2006 Jul;117(7):1545-50. doi: 10.1016/j.clinph.2006.03.026. Epub 2006 Jun 5.

Reference Type BACKGROUND
PMID: 16737848 (View on PubMed)

Hong CZ, Simons DG. Pathophysiologic and electrophysiologic mechanisms of myofascial trigger points. Arch Phys Med Rehabil. 1998 Jul;79(7):863-72. doi: 10.1016/s0003-9993(98)90371-9.

Reference Type BACKGROUND
PMID: 9685106 (View on PubMed)

Hong CZ. Treatment of myofascial pain syndrome. Curr Pain Headache Rep. 2006 Oct;10(5):345-9. doi: 10.1007/s11916-006-0058-3.

Reference Type BACKGROUND
PMID: 16945250 (View on PubMed)

Giamberardino MA, Affaitati G, Fabrizio A, Costantini R. Myofascial pain syndromes and their evaluation. Best Pract Res Clin Rheumatol. 2011 Apr;25(2):185-98. doi: 10.1016/j.berh.2011.01.002.

Reference Type BACKGROUND
PMID: 22094195 (View on PubMed)

Skootsky SA, Jaeger B, Oye RK. Prevalence of myofascial pain in general internal medicine practice. West J Med. 1989 Aug;151(2):157-60.

Reference Type BACKGROUND
PMID: 2788962 (View on PubMed)

SOLA AE, RODENBERGER ML, GETTYS BB. Incidence of hypersensitive areas in posterior shoulder muscles; a survey of two hundred young adults. Am J Phys Med. 1955 Dec;34(6):585-90. No abstract available.

Reference Type BACKGROUND
PMID: 13268620 (View on PubMed)

Hong CZ. Lidocaine injection versus dry needling to myofascial trigger point. The importance of the local twitch response. Am J Phys Med Rehabil. 1994 Jul-Aug;73(4):256-63. doi: 10.1097/00002060-199407000-00006.

Reference Type BACKGROUND
PMID: 8043247 (View on PubMed)

Ge HY, Fernandez-de-Las-Penas C, Madeleine P, Arendt-Nielsen L. Topographical mapping and mechanical pain sensitivity of myofascial trigger points in the infraspinatus muscle. Eur J Pain. 2008 Oct;12(7):859-65. doi: 10.1016/j.ejpain.2007.12.005. Epub 2008 Jan 18.

Reference Type BACKGROUND
PMID: 18203637 (View on PubMed)

Other Identifiers

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HC-GDOR-MIOFASCIAL

Identifier Type: -

Identifier Source: org_study_id

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