Dry needling and muscle mechanical properties in myofascial trigger points: a systematic review and meta-analysis

To systematically evaluate the effects of dry needling on myofascial mechanical properties in adults with active or latent myofascial trigger points through a systematic review including randomized controlled trials comparing dry needling with sham or noninvasive treatments.

Searches in MEDLINE, PubMed, Embase, Scopus, and Web of Science databases were conducted up to July 2025. The primary outcome was stiffness, whereas tone and elasticity were secondary, measured with shear-wave elastography or myotonometry. The meta-analysis was conducted under random-effects models with restricted maximum likelihood. The risk of bias was assessed with RoB 2.0, and certainty with the GRADE scale (PROSPERO: CRD420251081108).

Eleven randomized controlled trials encompassing 612 participants were included, of which 10 contributed to meta-analysis. Dry needling reduced stiffness in the short term (SMD -0.37, -0.64 to -0.11; I² = 36%). No immediate or mid-term effects emerged. Subgroup analyses suggested greater benefits in healthy participants (SMD -0.33, -0.58 to -0.07; I² = 49.9%). Shear-wave elastography and myotonometry showed comparable patterns, though heterogeneity was higher in elastography. The certainty of outcomes ranged from very low to low.

Dry needling reduces myofascial short-term stiffness, particularly in latent myofascial trigger points. Beyond estimating treatment effects, the present findings highlight the potential role of device-based measurements in supporting and refining the clinical assessment of myofascial trigger points. Future well-designed and standardized trials with longer follow-up are needed to clarify whether objectively measured changes in stiffness correspond to clinician-perceived palpatory findings and to determine their relevance within multimodal clinical decision-making.