The Influence of Dry Needling on Risk Factors of Neuroischemic Diabetic Foot Ulcers: A Case Series

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

To evaluate the effect of dry needling (DN) on neuropathy and blood circulation in ten patients with neuroischemic diabetic foot ulcers.

Methods:

A sample of ten patients (age range = 40–70 years) with neuroischemic ulcers were recruited and provided informed consent. These patients showed poor recovery after conventional wound care treatment. The target muscles were needled for 1 minute following which needles were left in each point for 10 minutes. The patients received 8 sessions of DN treatment with a frequency of two sessions per week with 48 hours interval between sessions in 4 weeks. The main outcome measures were Michigan Neuropathy Screening Instrument (MNSI) and neurothesiometer to evaluate neuropathy and Ankle Brachial Index (ABI) for the assessment of vascular status and blood flow. The assessments were conducted before the first session and after the eighth session of DN.

Results:

Following dry needling, blood circulation and neuropathy showed significant improvements. ABI scores improved from 0.7 to 1.02 (p = 0.004), representing a 45.71% improvement. Michigan Neuropathy Scores decreased by 3.4 (p = 0.019), representing a 30.36% improvement from the baseline of 11.2. Neurothesiometer scores improved by 7 (p = 0.013), representing a 25.18% improvement from the baseline of 27.8.

Conclusion(s):

This study demonstrates the potential of dry needling as an adjunctive therapy for neuroischemic or ischemic diabetic foot ulcers. Dry needling showed significant improvement in PVD-related outcomes, such as blood circulation and neuropathy. Future research should explore the potential to enhance the efficiency of dry needling by increasing the sample size and comparing the effects of dry needling with those of a control group. Additionally, future studies could investigate the efficacy of dry needling when combined with other complementary therapies. Such investigations could lead to a better understanding of the mechanisms underlying the effects of dry needling and help optimize its use in management of musculoskeletal conditions.

Implications:

This novel approach could be a complementary treatment option, augmenting conventional treatment strategies, particularly for those who are not suitable for interventions such as angioplasty due to comorbidities.

Funding acknowledgements:
This research was supported by funding from Tehran University of Medical Sciences,Tehran, Iran.
Keywords:
Dry needling
Neuroischemic ulcer
Diabetes
Primary topic:
Musculoskeletal: lower limb
Second topic:
Disability and rehabilitation
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?:
Yes

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