Wednesday, March 15, 2017

Study Spotlight: Use of Dx Ultrasound to Quantify Tissue Changes After Dry Needling of Myofascial Trigger Points

By: Joel Luedke

Well if I haven't lost you already due to the name of the blog post I promise it is worth your while. Dry needling has been a relatively new and very rapidly upcoming treatment for a multitude of pathologies.  There has been great promise being shown in the treatment of soft tissue/musculoskeletal injury as well as tendinopathies.  Utilizing this technique along with diagnostic ultrasound for exact treatment takes it to another level and this article takes a look at a new way to get more out of a dry needling treatment.

What They Did: 
Researchers in this study used a newer scale of measuring muscle tissue properties called the mechanical heterogeneity index.  This index is measured utilizing vibration elastography which can give a mechanical reading of the quality of the muscle tissue that you are observing.  

In this study they utilized patients that were having myofascial pain in their upper trapezius.  The trigger points that are thought to be causing the pain were evaluated on the mechanical heterogeneity scale, via pressure-pain threshold and palpation.  Patients were then in an interventional treatment of 3 weekly dry-needling treatments for the active myofascial trigger points.

What They Found:
The basics of what the researchers found was with dry needling treatments the trigger points did response and they were able to see with with the mechanical heterogeneity index.  They also saw improvements with palpation and with the pressure-pain threshold with a majority of the trigger points they measured.

What It All Means:
The cool thing that comes out of this study is not that dry needling works, most people could have told you that prior to any studies from their own personal experience, but that there is an objective way to quantitatively measure the resolution of trigger points.  While utilizing vibration elastography is new and still kind expensive you may wonder why we need it.  I think these results give way to a much bigger potential of utilization of the technology not just for trigger points that are commonly felt and when treated can also been seen as resolved.  I think this opens up a door for very complex pain pathologies such as complex regional pain syndrome and fibromyalgia.  If there can be an objective way to find and quantify the trigger points that could be underlying these pathologies it may hold a new hope for conservative treatment.

Either way it is really cool to be able to compare the subjective feeling of relief with true change in tissue quality.  Check out a full demonstration below.

Clinically Pressed Clinical Insight-Cait Larsen: Dry Needling

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