Last June JOSPT released a systematic review and meta-analysis of trigger point dry needling (TDN) (1); and during this past year, some classmates and I reviewed it. There was indeed mixed feelings about the review and the topic itself. I know this is a hot/touchy topic in PT right now and it’s a very “sexy” treatment idea, but I think if we are continuing to push towards an evidence based field (i.e. science based)…we should pump the breaks a bit with TDN.
I’m not advocating throwing the baby out with the bath water, but I do feel we (in general) need to be more skeptic and critical of a treatment/intervention that has been around in various forms for thousands of years and failed to reach scientific validity. No, I’m not saying that those who choose to utilize TDN believe that they are fixing internal organs and realigning people’s meridians. I am saying, however, that people have been sticking other people with needles to fix problems for thousands of years–and they have failed to produce scientific proof of the validity for such treatments. If we aren’t even sure of the method of action, how the treatment effect is produced(2), how can we then turn around and use it as a treatment?
It’s easier to whip out the old hammer and start hammering away at life’s problems, and clearly it’s more difficulty to think rationally and deduce what problem a person is actually having–and then how to fix it (or if it’s even something we can fix).
JOSPT seemingly pushed aside science to advocate the use of TDN. Fortunately, the great people over at Body in Mind decided to review the review. In response they wrote JOSPT a letter. Here’s a snippet of the letter:
The article itself suggests the available data are flimsy (not least because of the so-called garbage in – garbage out phenomenon – if the original articles are crap, then the best the systematic review can do is to collate crap), but if anything, the systematic review actually showed that dry needling is probably no better than sham and very possibly, it is measurably worse than comparative treatments.
The rest, I will leave for you to read. Heres the link!
And to be fair–TDN is not like the featured image above, but I’m pretty sure it doesn’t look like this either:
Please leave your comments/thoughts below.
(Correction: In a previous post, I referenced the APTA instead of JOSPT…whoops.)
Keitrys D, Polambaro K, Azzeretto E, et al. Effectiveness of Dry Needling for Upper-Quarter Myofascial Pain: A Systematic Review and Meta-analysis. Journal of Orthopaedic & Sports Physical Therapy. June 2013; 43:9; 620-634. doi:10.2519/jospt.2013.4668
- Cagnie B, Dewitte V, Barbe T, et al. Physiologic Effects of Dry Needling. Curr Pain Headache Rep. June 2013; 17:348.