PM R. 2024 Dec 6. doi: 10.1002/pmrj.13289. Online ahead of print.

ABSTRACT

BACKGROUND: Dry needling (DN) has been demonstrated as an effective treatment for patients with fibromyalgia (FM). It is crucial to take into consideration catastrophizing, a psychological construct that could potentially undermine the short-term efficacy of DN.

OBJECTIVE: To analyze the effects of DN in the infraspinatus muscle on both local and remote pressure pain thresholds (PPTs) and its relationship with baseline levels of pain catastrophizing in patients with FM.

DESIGN: Randomized controlled trial.

METHODS: All participants were randomly assigned to one of three interventions: DN, sham DN, and no intervention. Hong’s fast-in and fast-out technique was implemented during the DN intervention.

MAIN OUTCOMES MEASURES: The primary study outcome pain sensitivity (local and remote PPTs) was assessed at baseline, immediately post, and 24 h post intervention to evaluate short-term effect. Pain catastrophizing was measured at baseline in all participants using the Pain Catastrophizing Scale. To analyze the effect of DN on local and remote PPTs, an analysis of covariance was performed using catastrophism as covariate. Additionally, to examine the possible influence of catastrophism on local PPTs ratings in the subsequent assessment we performed a moderation analysis.

PATIENTS: A total of 120 women diagnosed with FM. However, during the follow-up period, 24 participants discontinued their involvement, leaving a final cohort of 96 patients who successfully concluded the study.

RESULTS: DN showed significant differences in both local PPTs immediately post intervention and 24 h post intervention (MD [95% confidence interval] = 3.21 [0.40-6.02] kg/cm², p = .019; and 2.84 [0.10-5.58] kg/cm², p = .039, respectively) compared to sham and no-intervention groups. In addition, DN group results suggest that moderate values of catastrophizing (<35) diminish the effect of DN immediately postintervention.

CONCLUSIONS: The infraspinatus DN led to a notable reduction in local PPTs among individuals with FM. Additionally, the effectiveness of the DN treatment was influenced by pain catastrophizing.

PMID:39641330 | DOI:10.1002/pmrj.13289