Exercise and dry needling for shoulder pain and dysfunction

Exercise and dry needling for shoulder pain and dysfunction Blog

Exercise and dry needling for shoulder dysfunction and pain
Experiencing chronic shoulder pain can be debilitating for people who suffer from it. There are numerous different treatment approaches that have varying levels of efficacy. Among conservative treatments, the options may include physical and manual therapy, exercise, acupuncture and dry needling.

While exercise has previously been shown to offer patients an effective treatment and outcome, a recent study demonstrates that combining dry needling with exercise may be a better treatment option than exercise alone.

What is dry needling?

People have trigger points in their muscles. When they become irritated, they can cause the knots that people feel in their muscles along with pain. Dry needling involves using hollow-point acupuncture needles or hypodermic needles to manipulate the trigger points in the shoulder muscles. Prior research has demonstrated that manipulating the trigger points in the muscles can help to change the muscle patterns and alleviate the experienced pain.

Study of the efficacy of exercise alone vs. exercise with dry needling

In the study, the researchers randomly divided 50 patients who suffered from chronic shoulder pain and who had been clinically diagnosed with it according to guidelines into two groups. In one group, the participants received a program of exercise alone. In the second group, the participants received the same exercise program but also received dry needling therapy. The researchers assessed the participants for their shoulder pain and their associated shoulder dysfunction. The assessments were completed according to the following schedule:

  •  Prior to the start of the study
  •  After one week of treatment
  •  After three months of treatment
  •  After six months of treatment
  •  After one year of treatment

Results

The participants who received both the exercise program and the dry needling therapy showed greater improvements in the functionality of their shoulders than did the group that received the exercise program alone. These improvements were seen at each assessment period following the beginning of the study. Both groups demonstrated no difference in the amount of pain that was alleviated, however.

Recommendations

While adding dry needling as a therapy in addition to exercise may not result in greater pain improvements, this study demonstrates that its addition may result in better shoulder functioning. Shoulder dysfunction, including such things as a more limited range of motion, may prevent people from being able to complete the normal tasks of their daily lives and of their jobs.

Adding dry needling to the therapeutic regimens of people who are suffering from chronic shoulder pain and dysfunction may be indicated for help with the functional improvements.

When people experience chronic pain in their shoulders, they may also have worse functional ability in their shoulders. Exercise has been shown to be a good therapeutic approach to people who suffer from chronic shoulder pain.

As this study demonstrates, people may want to talk to their doctors about adding dry needling to their therapeutic regimens so that they might be able to enjoy better functional improvements along with pain alleviation.

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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

image

Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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