Objective
To evaluate the current evidence of the effectiveness of dry needling of myofascial trigger points (MTrPs) associated with low back pain (LBP).
Data Sources
PubMed, Ovid, EBSCO, ScienceDirect, Web of Science, Cochrane Library, CINAHL, and China National Knowledge Infrastructure databases were searched until January 2017.
Study Selection
Randomized controlled trials (RCTs) that used dry needling as the main treatment and included participants diagnosed with LBP with the presence of MTrPs were included.
Data Extraction
Two reviewers independently screened articles, scored methodologic quality, and extracted data. The primary outcomes were pain intensity and functional disability at postintervention and follow-up.
Data Synthesis
A total of 11 RCTs involving 802 patients were included in the meta-analysis. Results suggested that compared with other treatments, dry needling of MTrPs was more effective in alleviating the intensity of LBP (standardized mean difference [SMD], −1.06; 95% confidence interval [CI], −1.77 to −0.36; P=.003) and functional disability (SMD, −0.76; 95% CI, −1.46 to −0.06; P=.03); however, the significant effects of dry needling plus other treatments on pain intensity could be superior to dry needling alone for LBP at postintervention (SMD, 0.83; 95% CI, 0.55–1.11; P<.00001).
Conclusions
Moderate evidence showed that dry needling of MTrPs, especially if associated with other therapies, could be recommended to relieve the intensity of LBP at postintervention; however, the clinical superiority of dry needling in improving functional disability and its follow-up effects still remains unclear.

Section Snippets
Methods
This systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.22
Study selection
A total of 784 articles were identified from PubMed, Ovid, EBSCO, ScienceDirect, Web of Science, Cochrane Library, CINAHL, and China National Knowledge Infrastructure databases, the reference lists of the included studies, and relevant reviews for eligible studies (fig 1). After applying the inclusion and exclusion criteria, 11 RCTs11, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39 were eligible and included in the systematic review and meta-analysis, with a total of 802 patients.
Study characteristics
Table 1 summarizes the…
Discussion
This systematic review summarizes the totality of evidence to date in relation to the effectiveness of dry needling for the treatment of LBP and includes a total of 11 RCTs involving 802 patients with LBP. The low-to-moderate-quality evidence showed that compared with other treatments, dry needling resulted in significant reduction in pain intensity and functional disability at postintervention. However, dry needling plus other treatments for LBP was more effective than dry needling alone in
Conclusions
Despite its limitations, this systematic review and meta-analysis provided a moderate quality of evidence recommending dry needling over other treatments to relieve the pain intensity of LBP at postintervention. However, scientific evidence proving the effectiveness of dry needling of MTrPs on LBP compared with other treatments at follow-up remains insufficient. Accordingly, more multiple-center RCTs with high-quality, large samples, and adequate follow-up, should be conducted to provide
Suppliers
a. RevMan 5.3; The Nordic Cochrane Centre.
b. Stata 12.0; StataCorp.

Read full article here: https://www.sciencedirect.com/science/article/abs/pii/S0003999317304525