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  1. Martin P Schwellnus
  1. Department of Human Biology, University of Cape Town, Cape Town, South Africa

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Dry needling of myofascial trigger points (MTPs) effectively reduces pain and disability up to 14 days after treatment—there is little difference in the use of different-sized needles.

Comparison of three needle sizes for trigger point injection in myofascial pain syndrome of upper- and middle-trapezius muscle: a randomised controlled trial


MTPs are small highly sensitive areas in the muscle that are painful to palpation and can cause referred pain—dry needling of MTP's is a commonly used treatment method.

Research question/s

Does the needle diameter of needles used in dry needling of MTPs affect pain during needling and treatment efficacy (pain, disability) after 2 weeks' follow-up?


Subjects: Seventy-seven patients with myofascial pain syndrome (>3 months) (upper- and middle-trapezius muscles).

Experimental procedure: All the subjects were assessed (including neck and upper back pain—Visual Analogue Scale (VAS); Neck Disability Index—NDI; Quality of life from Medical Outcomes Study 36-Item Short-Form Health Survey—SF-36). Subjects were randomised into three groups (n=25 each) receiving trigger point injections on one side of the trapezius with a large- (21), intermediate- (23) or small-gauge (25) needle. Pain during injection was evaluated immediately after injection (VAS). Following the injection, subjects were followed up at 1, 4, 7 and 14 days.

Measures of outcome: Pain (VAS); NDI; quality of life (SF-36); pain intensity during injection (VAS).

Main finding/s

  • Pain: There was a significant decrease in pain (VAS) in all three groups from day 4 post-treatment.

  • Pain intensity during injection (VAS score) was not significantly different between the groups.


Dry needling of MTPs effectively reduces …

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  • Provenance and peer review Not commissioned; not externally peer reviewed.