Does dry needling relieve pain caused by trigger points?

Question

My physiotherapist suggested dry-needling. I waved him off saying that I don't believe in acupuncture, but he insists it is different. He gave me a leaflet which tells about sticking needles into 'trigger points', which apparently has some kind of benefit for the muscles.

My question: is there any research on this topic? Or is this just a new marketing ploy for acupuncturists?

This is the translated (from Dutch) blurb on the little leaflet:

Dry Needling

Dry Needling is a relatively unknown form of therapy in the Netherlands. Only in recent years has it been used in the Netherlands by physiotherapists. With Dry Needling, muscle knots (trigger points) are punctured with a dry acupuncture needle, which cause the muscle to relax rapidly and prolonged. Trigger points cause local pain also pain at a distance.

Dry Needling differs from acupuncture in that dry needling focuses on the trigger points and acupuncture focuses on the energy system. Dry Needling treatment falls within the physiotherapy treatment.

Trigger points can be expressed as:

• pain / stiffness locally in muscle pain and elsewhere 'remote'
• restriction of movement in joints
• decreased strength in the muscle (s)
• pain avoidance behavior. (Moving different than normal)
• tingling in arms / legs, headaches, dizziness.

How could trigger points arise?

• Acute time - eg through a wrong move (above ourselves) or accident / sports injuries.
• Chronic - eg by a prolonged poor posture and / or RSI / CANS.
• Prolonged absence of movement, eg plaster, brace or sling.
• "Weak" incidental ligaments ankles and / or knees.
• Psychological factors such as stress and depression.
• Foot Abnormalities, instability and / or differences in leg length, eg after a fracture or surgery.
• Too tight clothing or improper wearing a backpack.

Answer 1

In conclusion, there is limited evidence deriving from one study that deep needling directly into myofascial trigger points has an overall treatment effect when compared with standardised care. Whilst the result of the meta-analysis of needling compared with placebo controls does not attain statistically significant, the overall direction could be compatible with a treatment effect of dry needling on myofascial trigger point pain. However, the limited sample size and poor quality of these studies highlights and supports the need for large scale, good quality placebo controlled trials in this area.

Acupuncture and dry needling in the management of myofascial trigger point pain: a systematic review and meta-analysis of randomised controlled trials. Tough EA, White AR, Cummings TM, Richards SH, Campbell JL.

Answer 2

John Quintner is an expert in the research into dry-needling. He argues trigger points don't exist. He wrote Body in Mind's Trigger Point Evaluation article, and was a co-author of a debate article, The Decline and Fall of the Trigger Point Empire.