Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies


Objective: The objective of this selective EBM review is to determine whether or not the use of dry needling in one or more active myofascial trigger points in the trapezius muscle is effective in decreasing pain in adults.

Study Design: Review of three randomized control trials.

Data Sources: All articles were published in English between 2014 and 2016. Articles were obtained from peer-reviewed journals and databases using Cochrane Collaboration and PubMed.

Outcomes: The outcome measured was level of pain using the Visual Analogue Scale (VAS). The VAS asked participants to rate their pain on a scale of 0 (no pain) to 10 (maximal pain).

Results: Ziaeifar et al. (J Bodyw Mov Ther. 2014;18(2):298-305. doi: // proved that dry needling MTrPs in the upper trapezius muscle was effective in decreasing subjective pain intensity (P=0.000) and was significantly better at doing so than a trigger point compression technique on MTrPs (P=0.01). Cerezo-Tellez et al. (J Man Manip Ther. 2016;24(4):223-32. doi: 10.1179/2042618615Y.0000000004) revealed dry needling on top of stretching was effective in decreasing pain (P < 0.05) and was significantly more successful than passive stretching alone (P<0.05). Finally, Pecos-Martin et al. (Arch Phys Med Rehabil. 2015;96(5):775-781. doi: 10.1016/j.apmr.2014.12.016) found dry needling on an MTrP had a significantly greater decrease in pain intensity than dry needling 1.5 cm medially to an MTrP at both 1-week and 1-month post-treatment (P < 0.05).

Conclusions: All three articles in this evidence-based review demonstrated that the use of dry needling in one or more active MTrPs in the trapezius muscle is effective in decreasing pain in adults. Further, dry needling MTrPs was significantly more successful in decreasing pain than a trigger point compression technique of MTrPs, stretching, or dry needling 1.5 cm away from the MTrP. Future studies should include a broader age population, investigate the number of dry needling treatments needed for pain reduction, and explore the use of dry needling MTrPs in more than one muscle at a time.