Comparison of the Efficacy of Dry Needling and High-Power Pain Threshold Ultrasound Therapy with Clinical Status and Sonoelastography in Myofascial Pain Syndrome

Am J Phys Med Rehabil. 2016 Oct;95(10):e149-58. doi: 10.1097/PHM.0000000000000600.


Objective: The aim of this study was to compare the therapeutic efficacy of high-power pain threshold (HPPT) ultrasound therapy applied to the trigger points and dry needling (DN) in myofascial pain syndrome.

Design: Sixty-one patients were randomly assigned to an HPPT (n = 30) and dry needling (n = 31) groups. The primary outcome measures were the Visual Analog Scale (VAS) and Neck Pain and Disability Scale (NPDS), both at 1 week and 4 weeks after treatment. The secondary outcome measures were the number of painful trigger points, range of the tragus-acromioclavicular joint, the Short Form-36, the Beck Depression Inventory, the Beck Anxiety Inventory, and sonoelastographic tests after a 1-week treatment.

Results: More improvement was seen in anxiety in the HPPT group (P < 0.05). However, no significant differences were found between the groups with regard to other parameters (P > 0.05). A decrease in tissue stiffness was only seen in the HPPT group (P < 0.05). Significant posttreatment improvements were seen on all clinical scales in both groups (P < 0.05). After a treatment period of 4 weeks, a significant improvement was also observed on the visual analog scale and NPDS (P < 0.05).

Conclusions: Our study favors the efficacy of both treatment methods in myofascial pain syndrome. Although a significant decrease was shown in tissue stiffness with HPPT, neither of these treatments had an apparent superiority.

Publication types

  • Comparative Study

MeSH terms

  • Acupuncture Therapy / methods*
  • Adult
  • Elasticity Imaging Techniques / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myofascial Pain Syndromes / diagnostic imaging
  • Myofascial Pain Syndromes / therapy*
  • Neck Pain / diagnostic imaging
  • Neck Pain / therapy*
  • Pain Measurement
  • Pain Threshold
  • Treatment Outcome
  • Trigger Points
  • Ultrasonic Therapy / methods*