Article

Myofascial trigger point dry needling is frequently associated with
postneedling soreness, which can generate patient dissatisfaction and reduced
treatment adherence. Psychological factors may influence the perception of
postneedling soreness and the effectiveness of postneedling soreness treatments.
The objectives of the present study were to determine whether
catastrophizing, kinesiophobia, pain anxiety, and fear of pain are significant
predictors of postneedling soreness over time; and to analyze whether the
relationships between psychological variables and postneedling soreness vary as a
function of the postneedling soreness intervention, which included ischemic
compression, placebo or control (without treatment). DESIGN: Repeated-measures
observational study nested within a randomized controlled trial. SETTING:
University community. PARTICIPANTS: Healthy volunteers (N = 90; 40 men and 50
women) 18 to 39 years of age (mean +/- standard deviation 22 +/- 3 years).
METHODS: Catastrophizing, kinesiophobia, pain anxiety, and fear of pain were
evaluated as possible predictors of postneedling pain before dry needling in a
latent myofascial trigger point in the upper trapezius muscle. Participants were
then divided into a treatment group that received ischemic compression as a
postneedling intervention, a placebo group that received sham ischemic
compression, and a control group that did not receive any treatment. MAIN OUTCOME
MEASUREMENTS: Pain during needling and postneedling soreness were quantified
using a visual analogue scale during needling, after treatment, and at 6, 12, 24,
and 48 hours. RESULTS: A multilevel analysis revealed that individuals who
exhibited more catastrophic thinking showed less postneedling soreness intensity
immediately after needling in all participants (beta = -0.049). Pain-related
anxiety was linked to greater immediate postneedling soreness in the compression
condition (beta = 0.057). Finally, participants who exhibited more catastrophic
thinking showed a slower rate of decline in postneedling soreness levels over
time in the compression condition (beta = 0.038). CONCLUSIONS: Catastrophizing
was associated with lower levels of postneedling soreness immediately after
needling in all subjects. Although ischemic compression seems to be a useful
procedure to reduce postneedling soreness, its efficacy could be slightly reduced
in patients presenting higher scores of pain-related anxiety. Psychological
procedures may help to correct the distorted pain expectancies associated with
needling interventions and might also improve the effectiveness of ischemic
compression. LEVEL OF EVIDENCE: II.
CI - Copyright (c) 2017 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS