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Evaluation of the efficacy of dry-needling in the treatment of myofascial pain syndrome and its effects on pain

Grant number: 11/12518-9
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): October 01, 2011
Effective date (End): September 30, 2012
Field of knowledge:Health Sciences - Medicine
Principal Investigator:Daniel Ciampi Araujo de Andrade
Grantee:Marcus Yu Bin Pai
Home Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

INTRODUCTION: Myofascial Pain Syndrome (MPS) is a regional muscle pain disorder accompanied by trigger points. Trigger point dry needling is one of the most effective treatments available. It relies on mechanical disruption of trigger points, also inhibiting nociception. OBJECTIVES: To evaluate in a prospective and controlled study the analgesic efficacy of trigger point dry needling and its correlation with changes in local mechanical hyperalgesia, and other sensitivity markers including pain to supraliminal thermal stimulation (hot and cold) and its intensity. MATERIALS/METHODS: Randomized, double blind, placebo controlled trial in patients with MPS diagnosis in unilateral trapezius muscle from the Pain Clinic of HC-FMUSP from September 2011 to September 2012. The patients will be randomly assigned to one of the two groups: A (n=20) and S (n=20). The A group will receive actual treatment with trigger point dry needling. The Sham group will receive a sham treatment, with the needle inserted superficially in the skin, without reaching the muscle underneath it. A third group containing 20 healthy volunteers will be submitted exclusively to thermal quantitative sensorial (TQS) testing and will serve as a control group. The patients will answer to several questionnaires, will fill a pain diary to more accurately characterize its painful syndrome as also evaluating its basal pain pattern before and after treatment. For the evaluation of tactile, mechanical, static, and thermal sensitivity, and also hyperalgesia and the mapping of the painful area, all patients will be subject to several thermal quantitative sensorial testings before and after treatment as well. STATISTICAL ANALYSIS: The results will be expressed in +/- standard deviation. The normality of the data will be assessed by Kolmogorof-Smirnoff tests. If there are parametric variables, Student's t-test and analysis of variance (ANOVA) will be used. Correlation tests between nominal variables will be realized with Pearson's test and continuable variables will be studied with Spearman's rank correlation coefficient.