Effects of Dry Needling on Latent Myofascial Trigger Points of the Extensor Digitorum Communis
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Hong fast-in and fast-out dry needling, Rotational dry needling, Bipolar electrical dry needling, Monopolar electrical dry needling.
- Who it may be relevant to
- Registry conditions: Dry Needling Technique, Trigger Point Pain, Physical Therapy. Basic parameters: 18 years — 40 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Spain
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
Effects of Dry Needling and Electrical Dry Needling on Latent Myofascial Trigger Points of the Extensor Digitorum Communis: A Randomized Clinical Trial
Overview
This randomized single-blind clinical trial aims to compare the effects of different dry needling and electrical dry needling techniques applied to latent myofascial trigger points in the extensor digitorum muscle of the dominant forearm in healthy adults. Participants will be randomly allocated to one of five groups: a control group, a Hong fast-in and fast-out dry needling group, a rotational dry needling group, a bipolar electrical dry needling group, or a monopolar electrical dry needling group. The main outcomes will be post-needling soreness intensity and duration. Secondary outcomes will include pain during the needling procedure, pressure pain threshold assessed by algometry, handgrip strength, range of motion of finger flexion and wrist palmar flexion, perceived comfort during the intervention, and perceived interference of post-needling soreness with daily activities. Assessments will be performed at baseline, 5 minutes after the intervention, and at 24, 48, and 72 hours after the intervention.
Detailed description
Myofascial trigger points are hyperirritable spots located within a taut band of skeletal muscle. Latent myofascial trigger points do not cause spontaneous pain but may contribute to motor dysfunction, increased fatigability, reduced range of motion, and altered muscle performance. Dry needling is a commonly used physiotherapy technique for the treatment of myofascial trigger points. However, post-needling soreness is one of the most frequent adverse effects associated with this intervention and may influence patient comfort, adherence, and functional performance in the hours following treatment.
Electrical dry needling, also known as intramuscular electrical stimulation, combines dry needling with transcutaneous electrical nerve stimulation applied through the inserted needle. Different modalities of electrical dry needling are used in clinical practice, including bipolar and monopolar applications. Nevertheless, limited evidence is available regarding the effect of these techniques on post-needling soreness, particularly when short-duration monopolar stimulation is applied using a pointer-type device.
The aim of this randomized single-blind clinical trial is to compare the effects of different dry needling and electrical dry needling techniques applied to latent myofascial trigger points in the extensor digitorum muscle of the dominant forearm in healthy adults. The primary objective is to compare the effect of electrical dry needling versus Hong fast-in and fast-out dry needling on the intensity and duration of post-needling soreness. Secondary objectives include comparing post-needling soreness among the different dry needling techniques, analyzing immediate changes in handgrip strength, assessing changes in finger flexion and wrist palmar flexion range of motion, evaluating pain during the needling procedure, assessing pressure pain threshold by algometry, and analyzing perceived comfort and interference of post-needling soreness with daily activities.
Healthy adults with a latent myofascial trigger point in the extensor digitorum muscle of the dominant forearm will be recruited. Participants will be randomly assigned to one of five groups: control group, Hong fast-in and fast-out dry needling group, rotational dry needling group, bipolar electrical dry needling group, or monopolar electrical dry needling group. Participants in the control group will not receive any dry needling intervention but will undergo the same assessment schedule as the intervention groups.
In the Hong fast-in and fast-out dry needling group, a sterile needle will be inserted into the latent myofascial trigger point and repeated fast-in and fast-out movements will be performed. In the rotational dry needling group, a sterile needle will be inserted into the latent myofascial trigger point and a rotational dry needling technique will be applied according to the study protocol. In the bipolar electrical dry needling group, a sterile needle will be inserted into the latent myofascial trigger point, an adhesive electrode will be placed near the needle, and a TENS current will be applied for 15 minutes. In the monopolar electrical dry needling group, a sterile needle will be inserted into the latent myofascial trigger point and stimulation will be applied using a Pointer Plus Excel-II device for 3 minutes.
Outcome assessments will be performed at baseline and 5 minutes after the intervention. Post-needling soreness intensity and duration will also be recorded at 24, 48, and 72 hours after the intervention. The study will use separated roles for recruitment, assessment, intervention delivery, and data analysis in order to reduce bias. Outcome assessors and the researcher responsible for data analysis will be blinded to group allocation.
Interventions
- Other Hong fast-in and fast-out dry needling
The skin will be disinfected with 0.5% alcoholic chlorhexidine. With the participant in supine position, a sterile needle will be inserted into the latent myofascial trigger point of the extensor digitorum muscle. Once the needle has reached the trigger point, 10 fast-in and fast-out movements will be performed. The number of local twitch responses will be recorded. - Other Rotational dry needling
The skin will be disinfected with 0.5% alcoholic chlorhexidine. With the participant in supine position, a sterile needle will be inserted into the latent myofascial trigger point of the extensor digitorum muscle. Once the needle has reached the trigger point, the rotational dry needling technique will be applied according to the predefined study protocol. - Other Bipolar electrical dry needling
The skin will be disinfected with 0.5% alcoholic chlorhexidine. With the participant in supine position, a sterile needle will be inserted into the latent myofascial trigger point of the extensor digitorum muscle. Once a local twitch response has been obtained, the needle will remain inserted and will act as the negative pole. An adhesive electrode connected to the positive pole will be placed approximately one centimeter from the needle. A TENS current will be applied for 15 minutes at a freque - Other Monopolar electrical dry needling
The skin will be disinfected with 0.5% alcoholic chlorhexidine. With the participant in supine position, a sterile needle will be inserted into the latent myofascial trigger point of the extensor digitorum muscle. Once a local twitch response has been obtained, the needle will remain inserted in the trigger point. The metallic tip of the Pointer Plus Excel-II device will be placed in contact with the needle, and a TENS current will be applied for 3 minutes at a frequency of 2 Hz and a pulse widt
Primary outcome measures
- Post-needling soreness intensity [Time frame: 1 week]
Secondary outcome measures (5)
- Duration of post-needling soreness [Time frame: 1 week]
- Pain during needling [Time frame: Immediately after the intervention]
- Pressure pain threshold [Time frame: 1 week]
- Handgrip strength [Time frame: 1 week]
- Range of motion of finger flexion and wrist palmar flexion [Time frame: 1 week]
Eligibility criteria
Inclusion criteria
- Adults aged 18 to 40 years.
- Healthy participants with a latent myofascial trigger point in the extensor digitorum muscle of the dominant forearm.
- No pathology affecting the upper limb where the intervention will be applied.
- No episode of pain in the upper limb during at least the previous two months.
- No contraindications to dry needling or electrical dry needling techniques.
- Voluntary signature of the informed consent form.
- Willingness to follow the protocol proposed by the research team.
Exclusion criteria
- Needle phobia.
- Coagulation disorders.
- Pregnancy.
- Thyroid disorders.
- Altered skin integrity in the treatment area.
- Epilepsy.
- Local or systemic infection.
- Diagnosed neurological disorders affecting pain perception or neuromuscular function in the region of interest, such as multiple sclerosis or peripheral neuropathies.
- Generalized chronic pain conditions, such as fibromyalgia.
- Weekly use of analgesic medication, including anti-inflammatory drugs, opioids, or other pain-relieving medication.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Treatment
Study locations
Spain · 1 center
- Facultat de Medicina i Ciències de la Salut — Reus
Publications
- Gallagher EJ, Liebman M, Bijur PE. Prospective validation of clinically important changes in pain severity measured on a visual analog scale. Ann Emerg Med. 2001 Dec;38(6):633-8. doi: 10.1067/mem.2001.118863. PMID 11719741
- Kalichman L, Vulfsons S. Dry needling in the management of musculoskeletal pain. J Am Board Fam Med. 2010 Sep-Oct;23(5):640-6. doi: 10.3122/jabfm.2010.05.090296. PMID 20823359
- Fernandez-de-Las-Penas C, Dommerholt J. International Consensus on Diagnostic Criteria and Clinical Considerations of Myofascial Trigger Points: A Delphi Study. Pain Med. 2018 Jan 1;19(1):142-150. doi: 10.1093/pm/pnx207. PMID 29025044
- Perreault T, Ball A, Dommerholt J, Theiss R, Fernandez-de-Las-Penas C, Butts R. Intramuscular Electrical Stimulation to Trigger Points: Insights into Mechanisms and Clinical Applications-A Scoping Review. J Clin Med. 2022 Oct 13;11(20):6039. doi: 10.3390/jcm11206039. PMID 36294360
- Leon-Hernandez JV, Martin-Pintado-Zugasti A, Frutos LG, Alguacil-Diego IM, de la Llave-Rincon AI, Fernandez-Carnero J. Immediate and short-term effects of the combination of dry needling and percutaneous TENS on post-needling soreness in patients with chronic myofascial neck pain. Braz J Phys Ther. 2016 Jul 11;20(5):422-431. doi: 10.1590/bjpt-rbf.2014.0176. PMID 27410163
- Martin-Pintado-Zugasti A, Mayoral Del Moral O, Gerwin RD, Fernandez-Carnero J. Post-needling soreness after myofascial trigger point dry needling: Current status and future research. J Bodyw Mov Ther. 2018 Oct;22(4):941-946. doi: 10.1016/j.jbmt.2018.01.003. Epub 2018 Jan 17. PMID 30368339
- Brady S, McEvoy J, Dommerholt J, Doody C. Adverse events following trigger point dry needling: a prospective survey of chartered physiotherapists. J Man Manip Ther. 2014 Aug;22(3):134-40. doi: 10.1179/2042618613Y.0000000044. PMID 25125935
- Hong CZ. Lidocaine injection versus dry needling to myofascial trigger point. The importance of the local twitch response. Am J Phys Med Rehabil. 1994 Jul-Aug;73(4):256-63. doi: 10.1097/00002060-199407000-00006. PMID 8043247
Identifiers
NCT: NCT07672093 · 06/2026