There is currently no standardized form of dry needling. There is a general scarcity of extensive research in the field. Many studies published about dry needling are not randomized, contain small sample sizes, and have high dropout rates. A review recommended the usage of dry needling, compared to sham or placebo, for decreasing pain immediately after treatment and at 4 weeks in patients with upper quarter myofascial pain syndrome. However, the authors caution that "the limited number of studies performed to date, combined with methodological flaws in many of the studies, prompts caution in interpreting the results of the meta-analysis performed".
[16] Similarly, a second review of dry needling found insufficient high-quality evidence for the use of direct dry needling for short and long-term pain and disability reduction in patients with musculoskeletal pain syndromes. The same review reported that robust evidence validating the clinical diagnostic criteria for trigger point identification or diagnosis is lacking and that high-quality studies demonstrate that manual examination for the identification and localization of a trigger point is neither valid nor reliable between-examiners.
[17]
Three more recent reviews reached similar conclusions: little evidence supporting the use of trigger point dry needling to treat upper shoulder pain and dysfunction,
[5] evidence not robust enough to draw a clear conclusion about safety and efficacy,
[6] and that dry needling for the treatment of myofascial pain syndrome in the lower back appeared to be a useful addition to standard therapies, but stated clear recommendations could not be made because the published studies were small and of low quality.
[7] However, a retrospective analysis of 2,910 dry needling interventions as reported by Mabry, et al. identified no reported safety events when dry needling was performed by physical therapists.
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