The aim of this evidence summary is to summarize the findings on the effectiveness of DN on pain intensity in MPS across all body regions as well as to provide a recommendation for practitioners of DN. The aim of this evidence summary is to summarize the findings on the effectiveness of DN on pain intensity in MPS across all body regions as well as to provide a recommendation for practitioners of DN.
Cochrane, Embase and PubMed were searched to identify systematic literature reviews and meta-analyses published after the year 2020, examining the short (up to 1 months)- and long (> 1 months) term effects of DN on pain intensity in MPS compared to other active and passive treatment modalites. The included articles were assessed for methodological quality using AMSTAR 2. The certainty of the evidence was assessed using the GRADE approach.
Eight systematic reviews with five meta-analyses were included (n=7053). The effectiveness of DN varies depending on the time of examination and the assessment tools. The short-term effectiveness of DN is clearly demonstrated by the reduction in pain symptoms on the visual analog scale (VAS) and the numerical rating scale (NRS). The long-term effects of DN on pain reduction in MPS cannot yet be clearly determined due to the limited data available. The methodological quality of the included studies ranged from ‘critically low’ to ‘moderate’ and the overall quality of evidence according to GRADE was “very low”.
Based on GRADE, DN can only be weakly recommended (grade b) for the short-term reduction of pain in patients with MPS. To obtain verified findings on the long-terms effects, RCTs with a larger sample size and a higher methodological quality are needed.
Regarding pain reduction in patients with MPS, the following recommendations can be given for practitioners of DN: 1. short-term effects for pain decrements are most evident on the VAS and NRS 2. no evidence exists for long-term effects by DN on reduction of pain intensity in MPS.
trigger points
physiotherapy
