Science News: Dry Needling Versus Corticosteroid Injections To Treat Tendinopathy: A Systematic Review
Published September 12, 2024
Science News
Submitted by: Sarah Breevoort, MD, PhD
Edited by: Rebecca O'Bryan, MD
Citation: Aman IM, Zutshi K, Singla D. Dry needling versus corticosteroid injections to treat tendinopathy: a systematic review. J Int Soc Phys Rehabil Med. 2023;6(3):77-82. doi:10.1097/PH9.0000000000000014.
Summary: This study is looking at the comparison of dry needling to steroid injection for treating tendinopathy.
During physical activities and exercise there is increased stress and force exerted on the tendon which increases the risk of both traumatic and overuse injury. Tendon injuries have become a common health issue and often is a musculoskeletal mimic that is commonly referred for electrodiagnostic testing. Dry needling can be used to treat muscles, tendons, and neuromuscular bundles and can lower central and peripheral sensitization by affecting substance P, endorphin, and local blood flow. Several studies suggest that dry needling has a positive influence in treating tendinopathies. Similarly, corticosteroid injections are used to treat tendon injuries, however, also have several disadvantages and risks.
In this systematic review the authors compare dry needling with steroid injections for tendinopathy and their efficacy in reducing symptoms.
The authors identified 121 articles which included dry needling or corticosteroid injections as their treatment protocol and any type of tendinopathy as a condition. Based on eligibility criteria ultimately four articles were selected for review. In these studies, dry needling versus single dose corticosteroid methylprednisolone acetate injections were compared and follow up was done at several weeks, months, and up to 1 year in one study. Outcome measures included visual analog scale, numerical pain rating scale and functional outcome measures to compare the effect of dry needling and steroid injection.
Comments: Corticosteroid injection and dry needling have been widely used for the treatment of musculoskeletal conditions; however, it is unclear which intervention is the most effective. This study is one of a few recent systematic reviews that seeks to address this matter. This systematic review is a recent attempt to address the efficacy of in a head-to-head comparison of both dry needling and corticosteroid injections for the treatment of tendinopathy. The authors admit the limitation of small sample size of randomized controlled trials highlighting a potential opportunity for future studies. Both dry needling and corticosteroid injections are widely used for the treatment of tendinopathies, however, corticosteroid injections have more inherent risks, require more training or expertise for administration, and may not be as easily available understanding the comparative effectiveness has significant clinical utility. This review highlights the need for additional studies but does demonstrate the efficacy of dry needling for long-term treatment.
This article has relevance for the AANEM audience as many referrals for EDX studies are musculoskeletal mimics. Many tendinopathies present with pain at tendon insertion sites where common mononeuropathies also may cause discomfort. If EDX physicians or allied health staff could offer in clinic treatment that is both relatively safe and effective this could enhance patient care as well as increase provider satisfaction by being able to offer in lab treatment for study patients who often have normal EDX tests.
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