Laurie's Blogs.

Reviews courtesy of APTEI / Bahram Jam PT (www.aptei.com)

This guy does some great reviews!  And this one I thought I would like to share with you folks.  I think we have a tendency to learn something new and add it to everything we do, without thinking or learning about what the research actually says.  So… here’s some info as it relates to neck pain.  I would think that it could translate to other parts of the spine.

Dry Needling: Neck & Shoulder Pain 

Reference: Liu Let al Effectiveness of dry needling for myofascial trigger points associated with neck and shoulder pain: a systematic review and metaanalysis.  Arch Phys Med Rehabil. 2015 May;96(5):944-55.

This systematic review evaluated the evidence supporting the effectiveness of dry needling of myofascial trigger points (MTrPs) associated with neck and shoulder pain; 20 RCTs were included.

Conclusions #1: Dry needling is effective for relieving MTrP pain in the short and medium term.

Conclusions #2: Wet needling (i.e. lidocaine injections) is more effective than dry needling in relieving MTrP pain in the medium term.

Conclusions #3: Physiotherapy (i.e. manual therapy & exercise) is more effective than dry needling in relieving MTrP pain in the medium term

So what can we learn from all these studies?

Dry needling is a great adjunct to other physiotherapy interventions but perhaps for better long-term recovery, needling should not be used alone.

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Massage Therapy: Neck Pain

Reference: Cheng YH et al Efficacy of massage therapy on pain and dysfunction in patients with neck pain: a systematic review and metaanalysis. Evid Based Complement Alternat Med. 2014;2014:204360.

This systematic review evaluated the evidence supporting the effectiveness of massage therapy for neck pain; 15 RCTs were included.

Conclusions #1: Massage therapy is effective for relieving neck pain in the short term.

Conclusions #2: Massage therapy has not yet been shown to improve neck dysfunctions (e.g. ROM)

So what can we learn from all these studies?

Massage therapy is a great adjunct to other physiotherapy interventions but perhaps for better long-term recovery, it should not be used alone.

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Manual Therapy: Neck Pain

Reference: Schroeder J et al The outcomes of manipulation or mobilization therapy compared with physical therapy or exercise for neck pain: a systematic review. Evid Based Spine Care J. 2013 Apr;4(1):30-41.

This systematic review evaluated the evidence supporting the effectiveness of manual therapy (mobilizations & manipulations) for neck pain; out of 197 citations, 7 RCTs were included.

Conclusions #1: Manual therapy is effective for relieving neck pain in the short and long term.

Conclusions #2: Manual therapy is not superior to independent exercise therapies provided by PTs with respect to pain and disability for acute and chronic neck pain.

So what can we learn from all these studies?

Mobilizations & manipulations are a great adjunct to other physiotherapy interventions but perhaps for better long-term recovery, focus should be on prescribing independent exercises.

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