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This study aimed to compare the effects of dry needling (DN) versus placebo DN applied to the peroneus longus (PL) and tibialis anterior (TA) on neuromuscular control and static postural control in basketball players with chronic ankle instability (CAI). A single-blinded randomized controlled trial was conducted. Thirty-two male and female basketball players with CAI were randomly assigned to receive either DN (n = 16) or placebo DN (n = 16). Pre-activation amplitudes of PL and TA were assessed with surface electromyography (EMG) during a dynamic landing test. Center of pressure (CoP) displacement and sway variability in anterior-posterior (AP) and medio-lateral (ML) directions were measured with a force platform during a single leg balance test (SLBT). Measures were obtained prior to a single DN intervention, immediately after, at 48 h, and 1 month after. The DN group displayed a significant increase in PL and TA pre-activation values, which were maintained 1 month later. Significant reductions in the ML and AP displacements and sway variability of CoP were found for the DN group. These results showed improvements in feedback/feed-forward strategies following DN, including enhanced neuromuscular control and static postural control, with the potential to become a convenient and accessible preventive treatment in CAI subjects.

Objective: A network meta-analysis (NMA) of randomised clinical trials (RCTs) was performed aiming to compare the treatment outcome of dry needling, acupuncture or wet needling using different substances in managing myofascial pain of the masticatory muscles (TMD-M).

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Method: An electronic search was undertaken to identify RCTs published until September 2019, comparing dry needling, acupuncture or wet needling using local anaesthesia (LA), botulinum toxin-A (BTX-A), granisetron, platelet-rich plasma (PRP) or passive placebo versus real active placebo in patients with TMD-M. RCTs meeting the inclusion criteria were stratified according to the follow-up time: immediate post-treatment to 3 weeks, and 1 to 6 months post-treatment. Outcome variables were post-treatment pain intensity, increased mouth opening (MMO) and pressure threshold pain (PPT). The quality of evidence was rated according to Cochrane's tool for assessing risk of bias. Mean difference (MD) was used to analysed via frequentist NMA using Stata software.

Results: Twenty-one RCTs involving 959 patients were included. The quality of evidence of the included studies was low or very low. There was significant pain decrease after PRP when compared to an active/passive placebo and acupuncture. There was a significant improvement of MMO after LA (MD = 3.65; CI: 1.18-6.1) and dry needling therapy (MD = 2.37; CI: 0.66-4) versus placebo. The three highest ranked treatments for short-term post-treatment pain reduction in TMD-M (1-20 days) were PRP (95.8%), followed by LA (62.5%) and dry needling (57.1%), whereas the three highest ranked treatments at intermediate-term follow-up (1-6 months) were LA (90.2%), dry needling (66.1%) and BTX-A (52.1%) (all very low-quality evidence). LA (96.4%) was the most effective treatment regarding the increase in MMO followed by dry needling (72.4%).

Conclusion: Based on this NMA, one can conclude that the effectiveness of needling therapy did not depend on needling type (dry or wet) or needling substance. The outcome of this NMA suggests that LA, BTX-A, granisetron and PRP hold some promise as injection therapies, but no definite conclusions can be drawn due to the low quality of evidence of the included studies. This NMA did not provide enough support for any of the needling therapies for TMD-M.

You may have heard of a treatment called dry needling and wondered what it is or if it's right for you. While the name of the procedure may sound intimidating, dry needling is an accessible and commonly offered therapy for people with muscle, ligament or tendon pain.

During a dry needling treatment, one or more thin, monofilament needles are inserted into a muscle trigger point. A trigger point is a local band of tight, irritable and dysfunctional muscle tissue. This often emerges because of injury, overuse or poor movement patterns.

Trigger points can disrupt your muscle function, restrict your range of motion or cause pain and tenderness. Physical therapists or licensed acupuncturists perform an in-depth evaluation to determine if dry needling is appropriate. Then they discuss your symptoms while assessing mobility and muscle function to determine if trigger points are contributing to symptoms.

Dry needling is a safe technique for treating many musculoskeletal conditions, including shoulder pain, rotator cuff pain, biceps tendinitis, iliotibial band syndrome, Achilles tendinitis, low back pain, tennis elbow, whiplash or neck pain, headaches, muscle strains, hip pain and temporomandibular pain, also called TMJ.

Dry needling is performed by physical therapists and licensed acupuncturists trained in the procedure. Certification requirements vary by state. Most people report minor or no discomfort during treatment.

There are some similarities between dry needling and acupuncture. Both use thin needles inserted at various depths to treat symptoms. The health care professional also may gently move or manipulate the needles after placement. Both acupuncture and dry needling are safe treatments, and usually are part of a larger treatment plan. The treatments are widely embraced by many, including those who practice conventional or Western medicine.

However, there are significant differences between acupuncture and dry needling. Acupuncture has been used for about 3,000 years as a key component of traditional Chinese medicine. Its effectiveness has been studied rigorously.

Dry needling is a newer treatment and evolved in the last few decades. It focuses exclusively on treating musculoskeletal and neuromuscular pain by releasing trigger points. Acupuncture restores energy flow, while dry needling targets dysfunctional muscle trigger points.

Fewer needles are used during dry needling treatment. It's often paired with electrical stimulation to enhance the effects of the treatment. This combination causes a gentle contraction and relaxation of the irritable muscle, which helps the muscle relax further.

Talk with your primary care provider if you are experiencing muscle, tendon or ligament pain. Working together, you and your health care team will determine if dry needling is right for you. Like all medical treatments, dry needling should be considered carefully before proceeding.

Although the trial in this review suggests a poor effect of bleb needling compared to antiglaucoma medication, doubt remains as to whether the trial had enough power to detect a significant effect given the small number of eyes randomised. Power calculations were not reported in the trial and attempts to contact the authors were unsuccessful. Scott 1988 suggests the beneficial effects of medical management of encysted blebs. In a retrospective review of 181 eyes, 18 developed encysted blebs and were managed without needling. His argument that this was a high bleb phase best managed by medical treatment would seem to support the findings of this trial. Richter 1988, however, observed in his series that 15 of 56 eyes (26.8%) with encapsulated blebs ultimately required surgical revision because maximally tolerated medical therapy was insufficient to control IOP.

Anecdotal evidence of the apparent usefulness of bleb needling may be due to the concomitant use of antimetabolites during and after needling. This may improve IOP control as some reports have suggested (Shin 1993). Other studies report the need to repeatedly needle encapsulated blebs to achieve a satisfactory IOP control. Variation in technique of needling may also influence IOP control. The use of larger needles for needling and the technique of subscleral flap needling can affect IOP outcomes. Variable success rates have been reported for needling of blebs that have failed for reasons other than encapsulation although there are no reported randomised controlled studies in this group.

Physical therapists performing dry needling in Florida are required to meet the standards set forth in section 486.117, Florida Statutes (F.S.), and rule 64B17-6.008, Florida Administrative Code (F.A.C.)

Within 60 days of the effective date of rule 64B17-6.008, F.A.C., on April 19, 2021, or within 60 days of the intent to perform dry needling in Florida, a licensed and qualified physical therapist performing dry needling, shall submit to the Board of Physical Therapy Practice, Form DH5057-MQA, Physical Therapist Dry Needling Attestation.

An adverse medical incident that is a direct result of physical therapy treatment involving dry needling shall be reported within 15 days of the incident, using Form DH5053-MQA, Physical Therapy Dry Needling Adverse Medical Incident Report.

Since September 1, 2012, physical therapists desiring approval to perform dry needling in Georgia were required to provide the Board proof of education in OSHA Blood Borne Pathogens Standard and dry needling instruction consisting of a minimum of 50 hours total and competency assessment and achievement in a dry needling curriculum. You may not use Dry Needling techniques in Georgia without gaining approval from the board. Dry Needling permissions in the State of Georgia are available only to Georgia PT License Holders and PT Compact Privilege Holders.

Georgia PT license holders may gain approval of the Georgia State Board of Physical Therapy to engage in the practice of dry needling in the state of Georgia by providing the following documentation:

On June 5, 2020, the Nevada Legislative Commission approved the attached regulation prescribing the qualifications required for physical therapists to perform dry needling. In summary, the qualifications include the completion of at least 150 hours of certain didactic education and training in dry needling, and submission of documentation to the Nevada Physical Therapy Board. This education requirement includes at least 25 hours of didactic education and training provided through a postgraduate course of study that requires the successful completion of in-person written and practical examinations. e24fc04721