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Author Spotlight: Treating Frozen Shoulder with Small Needle Knife Therapy
Published on: November 17, 2023
The effect of rotator cuff trigger points dry needling on the stability and function of the upper limb in people with
Samira Ghasemi1, Leila Abbasi2, Narges Meftahi2
1Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Background:
Shoulder pain, a prevalent musculoskeletal disorder (lifetime prevalence: 6.7%-66.7%), is closely linked to rotator cuff dysfunction. While trigger points in these muscles are common in symptomatic individuals, their impact on shoulder stability and function remains poorly understood.
Purpose:
This randomized controlled trial examined whether dry needling of rotator cuff trigger points, compared with sham needling, improves pain, disability, shoulder stability, and functional outcomes in patients with chronic rotator cuff--related shoulder pain.
Study Design:
Randomized controlled trial.
Methods:
In total, 44 patients aged 18-45years with shoulder pain randomly assigned to two groups. The first group received deep dry needling on trigger points, while the second group received sham dry needling. The treatment was performed over three sessions. Shoulder stability (Closed Kinetic Chain Upper Extremity Stability Test), pain (Visual Analog Scale), disability (Quick version of the Disabilities of the Arm, Shoulder, and Hand Questionnaire), grip strength, and strength of internal and external shoulder rotators were measured at the baseline, at the end of the last session, and 1week after the intervention.
Results:
Dry needling significantly improved shoulder stability (MD=0.11, 95% CI=0.06-0.16), grip strength (MD=12.4 kg), and pain (MD=-35.6, 95% CI=-41.2 to -30.0) compared with sham needling (p<0.05). All improvements exceeded minimal clinically important differences. At 1-week follow-up, all outcomes favored dry needling with large effect sizes (d=1.09-2.16), exceeding Minimal Clinically Important Differences for Quick version of the Disabilities of the Arm, Shoulder, and Hand Questionnaire (Δ=15.9) and Visual Analog Scale (Δ=9.9). Time-group interactions confirmed sustained improvements in the treatment group (p<0.001). Post-treatment improvements in shoulder stability (Closed Kinetic Chain Upper Extremity Stability Test) were consistent across sexes, with no significant sex-by-group interactions (p>0.05).
Conclusions:
Deep dry needling of rotator cuff trigger points significantly improves shoulder function, stability, pain, and disability in patients with chronic shoulder pain. Clinicians should consider integrating this intervention into rehabilitation protocols for rotator cuff--related disorders, as it demonstrates clinically meaningful outcomes surpassing minimal important differences.
