DryNeedlingAltersTriggerPointsintheUpperTrapeziusMuscleandReducesPaininSubjectsWithChronicMyofascialPain

Myofascial pain syndrome (MPS) is a common clinical problem that accounts for 15% of general medical visits and negatively affects function and quality of life. A key feature of MPS is the myofascial trigger point (MTrP)—a palpable, painful nodule within a taut band of skeletal muscle. Active MTrPs are spontaneously painful, while latent MTrPs require palpation to reproduce pain. Despite widespread use of dry needling as a treatment for MPS, there has been limited research on whether this intervention actually changes the physical status of the MTrP itself, rather than just reducing pain.

This study aimed to fill that gap by examining whether dry needling could convert active MTrPs to latent or resolved states, and whether such changes correlated with pain reduction and functional improvement.

The researchers conducted a prospective, nonrandomized, controlled, interventional clinical study at a university campus. They recruited 56 volunteers with neck or shoulder girdle pain lasting more than 3 months who had active MTrPs in specific locations of the upper trapezius muscle. Of these, 52 subjects completed the study (23 male, 33 female; mean age 35.8 years). Two experienced physicians with over 20 years of practice each performed all evaluations and treatments.

Interobserver reliability was tested and found to be good (k = 0.74–0.87).

Subjects received three weekly dry needling sessions targeting a single active MTrP. The technique used a 32-gauge needle with superficial insertion, sometimes with rotational movement to elicit a local twitch response (achieved in approximately 70% of subjects on the first treatment, 66% on the second, and 50% on the third). Evaluations occurred at baseline and after the third treatment at 3 weeks.

The primary outcomes were pain measured by verbal analogue scale (VAS, 0–10), the Brief Pain Inventory (BPI), and MTrP status determined by digital palpation (active, latent, or resolved). Secondary outcomes included cervical range of motion, pain pressure threshold (PPT), Profile of Mood States (POMS), Oswestry Disability Index, and Short Form-36 (SF-36) health survey.

Of the 52 completers, 41 subjects (78.8%) showed a change in trigger point status from active to latent or resolved, while 11 subjects (21.2%) had no change (P < .001). Pain reduction was significant across all measures (P < .001 for VAS and BPI).

For cervical range of motion, there was significant improvement in rotational asymmetry for both unilateral and bilateral MTrP groups (P = .001 and P = .021, respectively). Pain pressure threshold at the treated site improved significantly in both unilateral and bilateral groups (P = .006 and P = .012, respectively). Side-bending range of motion improved significantly only in the unilateral group (P = .001).

Self-reported outcomes also improved significantly: SF-36 mental health (P = .019) and physical functioning (P = .03) subscales, and Oswestry Disability Index (P = .003 or P = .004 depending on table reference). POMS tension and mood scores also improved significantly (P = .012 and P = .013, respectively).

In regression analysis comparing responders (those whose MTrP status changed) versus nonresponders, the mean change in VAS score was −2.87 ± 0.16 for responders versus −1.00 ± 0.30 for nonresponders (P < .001). The mean change in BPI score was −1.32 ± 0.22 for responders versus 0.04 ± 0.38 for nonresponders (P = .002). Pain pressure threshold change was not significantly different between responders and nonresponders.

This study provides important evidence that dry needling does more than temporarily reduce pain—it can actually change the physical status of myofascial trigger points from active to latent or resolved states. The strong correlation between trigger point status change and pain reduction suggests that the MTrP is indeed a meaningful treatment target in myofascial pain syndrome.

For patients, this means that a short course of dry needling (three sessions over three weeks) may provide both immediate pain relief and a lasting change in the underlying muscle pathology. The associated improvements in mood, disability, and cervical range of motion suggest broader functional benefits beyond simple pain reduction.

For clinicians, the study supports using VAS as a sensitive outcome measure for dry needling treatment, while suggesting that pain pressure threshold may be less sensitive to change. The findings also highlight the value of including objective measures like trigger point palpation and cervical range of motion alongside patient-reported outcomes when evaluating treatment response. However, the lack of randomization, blinding, and a true control group means that a placebo effect cannot be ruled out, and the authors appropriately call for a randomized, placebo-controlled trial to definitively establish effectiveness.