Effects of spray and stretch on postneedling soreness and sensitivity after dry needling of a latent myofascial trigger point

Arch Phys Med Rehabil. 2014 Oct;95(10):1925-1932.e1. doi: 10.1016/j.apmr.2014.05.021. Epub 2014 Jun 10.


Objectives: To investigate (1) the effect of spray and stretch versus control on reducing postneedling soreness of 1 latent myofascial trigger point (MTrP) and (2) whether higher levels of psychological distress are associated with increased postneedling pain intensity.

Design: A 72-hour follow-up, single-blind randomized controlled trial.

Setting: University community.

Participants: Healthy volunteers (N=70; 40 men, 30 women) aged 18 to 36 years (mean age, 21±4y) with latent MTrP in 1 upper trapezius muscle.

Intervention: All subjects received a dry needling application over the upper trapezius muscle. Then, participants were randomly divided into 2 groups: an intervention group, which received spray and stretch over the needled trapezius muscle, and a control group, which did not receive any intervention.

Main outcome measures: Visual analog scale (at postneedling, posttreatment, and 6, 12, 24, 48, and 72h after needling), pressure pain threshold (at preneedling, postneedling, and 24 and 48h after needling). Psychological distress was evaluated by using the Symptom Checklist-90-Revised.

Results: Repeated-measures analysis of variance demonstrated a significant interaction between group and time (F3,204.8=3.19; P<.05; ηp(2)=.04) for changes in postneedling soreness. Between-group differences were significant only immediately after intervention (P=.002), and there were no differences found between groups after 6 hours of the intervention (P>.05). Repeated measures of covariance showed that none of the psychological covariates affected these results. Somatization, anxiety, interpersonal sensitivity, and hostility were significantly correlated (P<.05) with postneedling pain intensity. Repeated-measures analysis of variance did not show a significant effect of spray and stretch on mechanical hyperalgesia (F2.6,175=1.9; P=.131; ηp(2)=.02).

Conclusions: The spray and stretch had a short-term (<6h) effect in reducing postneedling soreness of a latent MTrP. Pressure pain threshold did not significantly change after spray and stretch. Psychological factors are related to postneedling pain.

Keywords: Needles; Pain; Pain threshold; Psychology; Rehabilitation; Trigger points.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Anesthetics, Local / administration & dosage*
  • Anxiety / psychology
  • Ethyl Chloride / administration & dosage*
  • Female
  • Healthy Volunteers
  • Humans
  • Male
  • Muscle Stretching Exercises*
  • Myalgia / etiology
  • Myalgia / prevention & control*
  • Myalgia / psychology
  • Needles / adverse effects*
  • Pain Measurement
  • Single-Blind Method
  • Somatoform Disorders / psychology
  • Superficial Back Muscles
  • Trigger Points*
  • Young Adult


  • Anesthetics, Local
  • Ethyl Chloride