The effect of dry needling for myofascial trigger points in the neck and shoulders: a systematic review and meta-analysis

J Bodyw Mov Ther. 2014 Jul;18(3):390-8. doi: 10.1016/j.jbmt.2013.11.009. Epub 2013 Nov 9.


Background: and purpose: The aim of this systematic review with meta-analysis is to determine the effect of dry needling in the treatment of MTrPs.

Methods: Searches were performed using the electronic databases AMED, EBM reviews, Embase, and Ovid MEDLINE (all from database inception-February 2012).

Study selection: Randomized controlled trials (RCTs) were included if they compared dry needling with another form of treatment or placebo and included pain intensity as an outcome.

Data extraction: Two blinded reviewers independently screened the articles, scored their methodological quality and extracted data.

Quality assessment: Physiotherapy Evidence Database (PEDro) quality scale and the Cochrane risk of bias tool were used.

Results: Four RCTs compared dry needling to lidocaine and one RCT compared dry needling to placebo. Meta-analyses of dry needling revealed no significant difference between dry needling and lidocaine immediately after treatment standardized mean difference (SMD) 0.41 (95%CI -0.15 to 0.97), at one month (SMD -1.46; 95% CI -2.04 to 4.96) and three to six months (SMD -0.28; 95% CI -0.63 to 0.07).

Discussion: Although not significant in the meta-analyses, there were interesting patterns favoring lidocaine immediately after treatment and dry needling at three to six months.

Keywords: Dry needling; Lidocaine; Myofascial trigger points; Randomised controlled trial.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Acupuncture Therapy / methods*
  • Anesthetics, Local / therapeutic use
  • Humans
  • Lidocaine / therapeutic use
  • Myofascial Pain Syndromes / therapy*
  • Neck*
  • Randomized Controlled Trials as Topic
  • Shoulder*
  • Trigger Points*


  • Anesthetics, Local
  • Lidocaine