Effectiveness of dry needling for headache: A systematic review

Abstract

Introduction: Non-pharmacological treatment of patients with headache, such as dry needling (DN), is associated with less morbidity and mortality and lower costs than pharmacological treatment. Some of these techniques are useful in clinical practice. The aim of this study was to review the level of evidence for DN in patients with headache.

Methods: We performed a systematic review of randomised clinical trials on headache and DN on the PubMed, Web of Science, Scopus, and PEDro databases. Methodological quality was evaluated with the Spanish version of the PEDro scale by 2 independent reviewers.

Results: Of a total of 136 studies, we selected 8 randomised clinical trials published between 1994 and 2019, including a total of 577 patients. Two studies evaluated patients with cervicogenic headache, 2 evaluated patients with tension-type headache, one study assessed patients with migraine, and the remaining 3 evaluated patients with mixed-type headache (tension-type headache/migraine). Quality ratings ranged from low (3/10) to high (7/10). The effectiveness of DN was similar to that of the other interventions. DN was associated with significant improvements in functional and sensory outcomes.

Conclusions: Dry needling should be considered for the treatment of headache, and may be applied either alone or in combination with pharmacological treatments.

Keywords: Cefalea; Cefalea cervicogénica; Cefalea tensional; Cervicogenic headache; Dry needling; Headache; Migraine; Migraña; Punción seca; Puntos gatillo; Tension-type headache; Trigger points.