A critical appraisal of "Rate and maintenance of improvement of myofascial pain with dry needling alone vs. Dry needling with intramuscular electrical stimulation: a randomized controlled trial"

The purpose of this paper is to provide a critical appraisal of the article "Rate and maintenance of improvement of myofascial pain with dry needling alone vs. dry needling with intramuscular electrical stimulation: a randomized controlled trial."� This appraisal began as an attempt to find relevant research comparing the practice of dry needling (DN) to dry needling with intramuscular electrical stimulation (DN/IMES) with regards to treating myofascial pain syndrome (MPS). The article was found through the Gale Onefile database, and it directly compares the two methods in questions. The authors make a thorough introduction of DN, DN/IMES and MPS, siting previous studies done on the topics, and identifying outcome measures for their own study. This single-blinded study compared two research groups, one receiving DN treatment and the other DN/IMES, without having a non-treatment control group to compare to. Both groups saw statistically significant improvement in NPRS and NDI scores over the 12-week period. However, the authors fail to recognize the potential benefits of the DN/IMES seeing significant improvements in NDI scores over the first 3 weeks, while the DN group did not. The authors do not use the MCID scores for NDI or NPRS to determine clinical significance. If they did, they would see that the DN/IMES group was the only one with clinically significant improvements throughout the study. Both DN and DN/IMES have the potential to relieve pain in patients with MPS. While the authors of the article fail to recognize the differences between the DN and DN/IMES groups, their data shows that DN/IMES at least has the potential to provide quicker and longer lasting pain relief. Further research is needed, using clinically accurate methods, to firmly establish whether one treatment method is more clinically significant than the other.