Author, Year Condition Funding source CoI | Methods | Participants | Interventions | Outcomes measures and time points | Results (outcomes, responder analysis, adverse events) |
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GĂŒngör and GĂŒngör [31] Lateral epicondylitis Not funded None | Randomized clinical trial conducted in Turkey from 2018 to 2020 | Sample size (n)* DN: 24 CSI: 24 Sex (Females) DN: 13F CSI: 15F Age (meanâ±âSD) DN: 46.0â±â7.4 years CSI: 40.9â±â7.7 years *This study had another intervention group, which received platelet-rich plasma (PRP) treatment (nâ=â24) | DN: A fine needle (23 gauge) was withdrawn and advanced throughout the long axis of the tendon about 40â50 times during 2 min to pepper the tendon. Dry needling was performed once a week for 3 weeks CSI: A single corticosteroid injection of 40 mg methylprednisolone acetate was administered with the patient seated on a chair and the forearm placed in the neutral position and the elbow in 90Âș of flexion | Pain intensity measured by using the Visual Analogue Scale (VAS) and function assessed through Disabilities of the Shoulder, Arm, and Hand (DASH) score before treatment, 3 weeks and 3 months follow-up | Pain (VAS) 3 wk: DN 2.3â±â0.6 versus CSI 2.3â±â0.6 pâ=â0.98 3mo: DN 1.1â±â0.5 versus CSI 0.7â±â0.6 pâ=â0.01 Function (DASH) 3wk: DN 31.6â±â6.8 versus CSI 32.0â±â5.0 pâ=â0.84 3mo: DN 30.0â±â6.7 versus CSI 26.6â±â3.2 pâ=â0.01 Responder analysis: Not reported Adverse events: Not reported |
Rastegar et al. [27] Plantar Fasciitis Medical Research Council at Isfahan University of Medical Sciences None | Randomized clinical trial conducted in Iran from April 2013 to April 2015 | Sample size (n) DN: 32 CSI: 34 Sex (Females) DN: 18F CSI: 20F Age (meanâ±âSD) DN: 39.8â±â7.9 years CSI: 42.0â±â10.3 years | DN: The medial aspect of heel pad through the point of maximum tenderness was dry needled for 30 s using a 0.3 mm diameter needle. The needle was withdrawn and advanced during the time CSI: 1 ml of methylprednisolone acetate (40 mg/ml) was injected to the medial aspect of heel pad through the point of maximum tenderness using a 0.3 mm diameter needle with 3 or 2 ml syringe | Pain intensity measured by VAS before treatment, 3 weeks, 6 weeks, 3 months, 6 months and 1 year after treatment | Pain (VAS) Short-term 3wk: DN 3.47â±â1.32 versus CSI 0.32â±â0.71 pâ<â0.001 6wk: DN 2.66â±â1.33 versus CSI 0.21â±â0.67 pâ<â0.001 Mid-term 12wk: DN 1.59â±â1.24 versus CSI 0.56â±â1.33 pâ=â0.44 Long term 6mo: DN 1.28â±â1.46 versus CSI 1.79â±â1.55 pâ=â0.65 1 yr: DN 0.69â±â0.93 versus CSI 2.09â±â1.58 pâ=â0.004 Responder analysis: Not reported Adverse events: Not reported |
Brennan et al. [26] Greater trochanteric pain syndrome Baylor Scott & White Health None | Prospective, randomized clinical trial conducted in USA between 2013 and 2015 | Sample size (n) DN: 21 CSI: 22 Sex (Females) DN: 19F CSI: 18F Age (meanâ±âSD) DN: 61.3â±â16.5 years CSI: 70.1â±â11.4 years | DN: Muscles assessed as contributing for patient pain was needled by a 0.3â0.5 mm diameter needle. The needle was withdrawn and advanced repeatedly while it produced an appropriate response and was tolerated by the participant. Then, the needle was left in situ for 5â7 min CSI: A 10 ml injection mixture containing 2 mL methylprednisolone acetate (40 mg/mL), 4 mL 1% lidocaine and 4 mL 0.25% marcaine was injected in the point of maximal tenderness on the greater trochanter with an area coverage of 3-4 cm by 3â4 cm. 2 mL were injected perpendicular to the skin to the level of bony contact; then, 2 mL were injected in each of 4 quadrants around the injection side. Needle length was 1.5 inch and diameter was 21 or 22 gauge, depending on soft tissue thickness | Pain intensity measured by NPRS and function measured by PSFS before treatment, 1 week, 3 weeks and 6 weeks after treatment | Pain (NPRS) Short term 1wk: DN 3.6â±â2.1 versus CSI 2.6â±â2.7 3wk: DN 4.0â±â2.2 versus CSI 2.7â±â2.9 6wk: DN 2.8â±â2.4 versus CSI 3.9â±â3.7 Disability (PSFS)Short term 1wk: DN 5.2â±â2.2 versus CSI 6.5â±â2.8 3wk: DN 5.7â±â2.0 versus CSI 6.5â±â2.8 6wk: DN 7.3â±â2.3 versus CSI 6.1â±â3.0 Responder analysis: Not reported Adverse events DN: 0% (nâ=â0) CSI: 0% (nâ=â0) |
Uygur et al. [30] Lateral epicondylitis Not reported None | Randomized clinical trial conducted in Turkey, | Sample size (n) DN: 49 CSI: 52 Sex (Females) â Age (meanâ±âSD) DN: 47.5â±â7.3 years CSI: 48.1â±â10.3 years | DN: Fifteen 0.25âĂâ25 mm needles were inserted at the lateral epicondyle region. The needles were rotated 3â4 times, held in place for 10 min, and withdrawn. Dry needling was performed twice a week for 5 sessions CSI: A single dose of corticosteroid injection containing 2 ml methylprednisolone acetate (40 mg/ml) was inserted into the lateral epicondyle region. The periosteum was pricked 90 20â30 times without withdrawing the needle and no local anesthetic was used | Patient improvement was assessed by using the Patient-rated Tennis Elbow Evaluation (PRTEE) before interventions, at 20th day and at 6 months follow-up | Patient improvement 20th day: DN 15.6â±â7.7 versus CSI 36.0â±â14.7 pâ<â0.01 6 months: DN 9.7â±â7.6 versus CSI 19.3â±â19.4 pâ<â0.01 Responder analysis: not reported Adverse events DN: 2% (nâ=â1) of participants did not tolerate pain due to intervention and was excluded from the study CSI: 7.6% (nâ=â4) of participants presented skin atrophy and whitening at 6-months follow-up |
Uygur et al. [28] Plantar fasciitis Not funded None | Randomized clinical trial conducted in Turkey | Sample size (n) DN: 49 CSI: 47 Sex (Females) N(%): 63F (66%)* Age (meanâ±âSD) DN: 49.6â±â11.7 years CSI: 49.9â±â12.3 years | DN: Fifteen-0.25âĂâ0.4 mm needles were inserted into the plantar fascia origin at the calcaneous. The needles were left in situ for 10 min and were rotated 3 to 4 times. Dry needling was performed twice a week for 5 sessions CSI: A single dose of corticosteroid injection containing methylprednisolone acetate (2 mL Depo Medrol, 40 mg/ml) and bupivacaine (1 mL marcaine, 0.5%) was injected between the plantar fascia and the periosteum. Needle diameter was 25 gauge | Pain intensity and disability score measured by the Foot Function Index (FFI) Before treatment, 3 weeks and 6 months after treatment | Pain (FFI Pain score) Short term 3wk: DN 27.7â±â9.82 versus CSI 33.6â±â10.6 Long term 6mo: DN 29.7â±â10.3 versus CSI 50.5â±â12.3 Disability (FFI Disability Score) Short term 3wk: DN ââ28.3â±â8.9 versus CSI ââ28.4â±â11.6* Long term 6mo: DN ââ28.8â±â8.8 versus CSI ââ43.1â±â11.1* Responder analysis: Not reported Adverse events DN: 38% (nâ=â18) of participants presented pain at the needling site and 12% (nâ=â6) reported subcutaneous bleeding CSI: 0% (nâ=â0) *multiplied by ââ1 to adjust the direction of the effect |
Venancio et al. [29] Myofascial pain and headache Not reported Not reported | Randomized clinical trial conducted in Brazil | Sample size (n) DN: 15 CSI: 15 Sex (Females) â Age (meanâ±âSD) â | DN: not sufficiently described CSI: Corticosteroid injection mixture containing 0.2 mL dexamethasone (4 mg/mL) and lidocaine (0.25%) | Pain measured by the modified Symptom Severity Index (SSI) Before treatment, 1 week, 4 weeks and 12 weeks after treatment | Pain (Modified SSI) Short term 1wk: DN 0.34â±â0.08 versus CSI 0.51â±â0.20 4wk: DN 0.42â±â0.08 versus CSI 0.43â±â0.11 Mid term 12wk: DN 0.36â±â0.17 versus CSI DN 0.33â±â0.1 Responder analysis: Not reported Adverse events: Not reported |