The Effect of Dry Needling on the Healing Process of Neuropathic Diabetic Foot Ulcers: A Randomized Controlled Trial

Soofia Naghdi, Mohammad Reza Amini, Jan Dommerholt, Noureddin Nakhostin Ansari, Fatemeh Hasannia
Purpose:

To evaluate the effect of dry needling (DN) as an adjuvant therapy on peripheral neuropathy and ulcer size in patients with neuropathic diabetic foot ulcers.

Methods:

A single-blind, randomized controlled trial was conducted. A control group received standard treatment, while the intervention group was administered with standard treatment as well as DN. Patients (n = 20) with neuropathic diabetic foot ulcers were randomly allocated in a 1:1 ratio to the dry needling (DN) or control group. The DN group received 8 sessions of dry needling, separated by 2 days, for 4 weeks, targeting the muscles innervated by the two nerves most commonly associated with diabetic foot ulcers. The treatment was followed up after 2 months. The main outcome measures were the Michigan Neuropathy Screening Instrument (MNSI) and neurothesiometer for evaluating neuropathy. Image j software was used to precisely measure the ulcer area.

Results:

The dry needling group experienced a significant reduction in ulcer size (p = 0.048) and neuropathy severity (p = 0.048) after 4 weeks, compared to the control group. Additionally, the dry needling group showed greater improvement in quality of life within 2 months (p = 0.000), as measured by the Michigan Questionnaire.

Conclusion(s):

Eight dry needling sessions significantly reduced neuropathy and ulcer size in patients with neuropathic diabetic foot ulcers, suggesting that dry needling may well be a promising adjuvant therapy. Future research should explore the potential to enhance efficacy by increasing the sample group size, or by combining with other therapies.

Implications:

The findings of this study not only highlight the efficacy of dry needling in treating patients with DFUs, but also suggest that addressing musculoskeletal dysfunction may have wider implications for chronic conditions such as diabetic foot ulcers. In diabetic patients with musculoskeletal dysfunction, physiotherapists can play a key role in managing and treating these issues, thereby reducing the burden on the healthcare system and improving patients' quality of life.

Funding acknowledgements:
This report was supported by funding from Tehran University of Medical Sciences,Tehran, Iran
Keywords:
Diabetic foot ulcers
Dry needling
Neuropathy
Primary topic:
Disability and rehabilitation
Second topic:
Musculoskeletal: lower limb
Third topic:
Other
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Approved by the review board of the School of Rehabilitation at the Ethics Committee of Tehran University of Medical Sciences
Provide the ethics approval number:
IR.TUMS.EMRI.REC.1402.074
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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