Publications
Comparative effects of static, classical, and sham dry needling on muscle properties and autonomic nervous system activity in cervical myofascial pain syndrome
Authors: Gracjan Olaniszyn 1, 2, Adrian Kuzdzal 3, Jakub Taradaj 4, Robert Trybulski 1, 5
Affiliations:
- Medical Department Wojciech Korfanty, Upper Silesian Academy in Katowice, Katowice 40-659, Poland
- Olaniszyn Physiotherapy Centre, Poland
- Institute of Physiotherapy, Faculty of Health Sciences and Psychology, Collegium Medicum, University of Rzeszow, Poland
- Institute of Physiotherapy and Health Sciences, Academy of Physical Education in Katowice, Katowice, Poland
- Provita Medical Centre, Zory, Poland
Journal: Complementary Therapies in Medicine - March 2026, Volume 96, Article no. 103314 (DOI: 10.1016/j.ctim.2025.103314)
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Field & Applications:
- Medical
- Treatment evaluation
- Complementary and Alternative Medicine
- Musculoskeletal disorder
Myoton Clarification Note: A Guide to Interpreting the Inverse Relationship Between Logarithmic Decrement and Tissue Elasticity
Background: Dry needling is frequently used for managing myofascial pain, yet the influence of needle manipulation technique on physiological responses remains uncertain.
Objective: To compare the short-term effects of classical dynamic (pistoning) dry needling (CDN), static dry needling (SDN), and sham needling (shamN) on mechanical and microcirculatory properties of the upper trapezius muscle.
Methods: In this randomized, single-blind, sham-controlled trial, 45 participants with upper-trapezius myofascial trigger points were allocated to CDN (n = 15), SDN (n = 15), or shamN (n = 15). CDN involved multiple fast in-out needle insertions to elicit local twitch responses, SDN consisted of a single needle insertion retained for 60 s without manipulation, and shamN simulated insertion without skin penetration. Outcomes included pressure pain threshold (PPT, N/m²), muscle stiffness (N/m), tone (Hz), elasticity (D), and perfusion (PU), recorded at baseline, immediately, 60 min, 24 h, and 7 days post-intervention. Data were analyzed with mixed (Group × Time) ANCOVA models using baseline as covariate.
Results: A significant main effect of time was observed for PPT (p = 0.039, η²ₚ = 0.071) and a significant Time × Group interaction for elasticity (p < 0.001, η²ₚ = 0.974) and perfusion (p < 0.001, η²ₚ = 0.483). Post hoc comparisons showed higher PPT and perfusion and lower stiffness and tone in CDN compared with SDN and shamN across most time points (p < 0.05). No significant differences were found between SDN and shamN.
Conclusions: CDN induced greater short-term improvements in mechanical and perfusion outcomes of the upper trapezius than static or sham procedures, suggesting that needle manipulation intensity modulates physiological responses. Long-term studies are warranted to confirm sustained clinical relevance. Trial registration: ISRCTN16484644
Keywords: dry needling, myofascial pain syndromes, muscle stiffness, blood flow velocity, trigger points
In conclusion, this study provides evidence that dynamic or pistoning dry needling produces greater short-term physiological benefits in the upper trapezius muscle compared with static or sham needling, as reflected by higher pressure pain thresholds, reduced stiffness and tone, transient increases in elasticity, and short-lived enhancements in local perfusion. These effects were most consistent immediately after treatment and at 24 h, suggesting that the mechanical characteristics of the needling technique play a meaningful role in modulating local tissue properties. The findings should be interpreted as indicative rather than definitive, emphasizing the potential of CDN to produce acute mechanical and microcirculatory changes, while reinforcing the need for further research to confirm whether these short-term physiological effects translate into sustained clinical improvement.