Corticosteroid injection or dry needling for musculoskeletal pain and disability? A systematic review and GRADE evidence synthesis

Abstract Background Corticosteroid injection and dry needling have been used in the treatment of musculoskeletal conditions, but it is unclear which intervention is the most effective. The purpose of this study was to compare the effects of corticosteroid injection and dry needling for musculoskelet...

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Autores principales:	Luis Fernando Sousa Filho, Marta Maria Barbosa Santos, Gabriel Henrique Freire dos Santos, Walderi Monteiro da Silva Júnior
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Pain Disability Steroids Acupuncture Manual therapy Chiropractic RZ201-275 Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/7dbe128df2b048ec8363c7fb63334680
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spelling	oai:doaj.org-article:7dbe128df2b048ec8363c7fb633346802021-12-05T12:25:28ZCorticosteroid injection or dry needling for musculoskeletal pain and disability? A systematic review and GRADE evidence synthesis10.1186/s12998-021-00408-y2045-709Xhttps://doaj.org/article/7dbe128df2b048ec8363c7fb633346802021-12-01T00:00:00Zhttps://doi.org/10.1186/s12998-021-00408-yhttps://doaj.org/toc/2045-709XAbstract Background Corticosteroid injection and dry needling have been used in the treatment of musculoskeletal conditions, but it is unclear which intervention is the most effective. The purpose of this study was to compare the effects of corticosteroid injection and dry needling for musculoskeletal conditions at short-, medium-, and long-term follow-up. Methods Electronic databases were searched up to 31 October 2021. Two researchers independently screened titles, abstracts and full-text articles. Randomized clinical trials (RCTs) that investigated the effectiveness of dry needling compared to corticosteroid injection in patients over 18 years with a musculoskeletal condition were included in the review. The studies had to report pain and/or disability as outcome. Risk of bias was assessed by using the revised Cochrane Collaboration tool (RoB 2.0). Quality of evidence was evaluated by using the GRADE approach. Results Six studies were included (n = 384 participants). Four musculoskeletal conditions were investigated. There is very low-quality evidence that CSI is superior to DN for reducing heel pain (plantar fasciitis) and lateral elbow pain at short- and medium-term follow-up, but not for myofascial pain and greater trochanteric pain. There is very low-quality evidence that DN is more effective than CSI at long-term follow-up for reducing pain in people with plantar fasciitis and lateral epicondylitis. Very low-certainty evidence shows that there is no difference between DN and CSI for disability at short-term follow-up. One study showed that CSI is superior to DN at medium-term follow-up and another observed that DN is superior to CSI for reducing disability at long-term. Conclusions There are no differences between DN and CSI in pain or disability for myofascial pain and greater trochanteric pain syndrome. Very-low certainty evidence suggests that CSI is superior to DN at shorter follow-up periods, whereas DN seems to be more effective than CSI at longer follow-up durations for improving pain in plantar fasciitis and lateral epicondylitis. Large RCTs with higher methodological quality are needed in order to draw more incisive conclusions. PROSPERO registration number CRD42020148650.Luis Fernando Sousa FilhoMarta Maria Barbosa SantosGabriel Henrique Freire dos SantosWalderi Monteiro da Silva JúniorBMCarticlePainDisabilitySteroidsAcupunctureManual therapyChiropracticRZ201-275Diseases of the musculoskeletal systemRC925-935ENChiropractic & Manual Therapies, Vol 29, Iss 1, Pp 1-14 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Pain Disability Steroids Acupuncture Manual therapy Chiropractic RZ201-275 Diseases of the musculoskeletal system RC925-935
spellingShingle	Pain Disability Steroids Acupuncture Manual therapy Chiropractic RZ201-275 Diseases of the musculoskeletal system RC925-935 Luis Fernando Sousa Filho Marta Maria Barbosa Santos Gabriel Henrique Freire dos Santos Walderi Monteiro da Silva Júnior Corticosteroid injection or dry needling for musculoskeletal pain and disability? A systematic review and GRADE evidence synthesis
description	Abstract Background Corticosteroid injection and dry needling have been used in the treatment of musculoskeletal conditions, but it is unclear which intervention is the most effective. The purpose of this study was to compare the effects of corticosteroid injection and dry needling for musculoskeletal conditions at short-, medium-, and long-term follow-up. Methods Electronic databases were searched up to 31 October 2021. Two researchers independently screened titles, abstracts and full-text articles. Randomized clinical trials (RCTs) that investigated the effectiveness of dry needling compared to corticosteroid injection in patients over 18 years with a musculoskeletal condition were included in the review. The studies had to report pain and/or disability as outcome. Risk of bias was assessed by using the revised Cochrane Collaboration tool (RoB 2.0). Quality of evidence was evaluated by using the GRADE approach. Results Six studies were included (n = 384 participants). Four musculoskeletal conditions were investigated. There is very low-quality evidence that CSI is superior to DN for reducing heel pain (plantar fasciitis) and lateral elbow pain at short- and medium-term follow-up, but not for myofascial pain and greater trochanteric pain. There is very low-quality evidence that DN is more effective than CSI at long-term follow-up for reducing pain in people with plantar fasciitis and lateral epicondylitis. Very low-certainty evidence shows that there is no difference between DN and CSI for disability at short-term follow-up. One study showed that CSI is superior to DN at medium-term follow-up and another observed that DN is superior to CSI for reducing disability at long-term. Conclusions There are no differences between DN and CSI in pain or disability for myofascial pain and greater trochanteric pain syndrome. Very-low certainty evidence suggests that CSI is superior to DN at shorter follow-up periods, whereas DN seems to be more effective than CSI at longer follow-up durations for improving pain in plantar fasciitis and lateral epicondylitis. Large RCTs with higher methodological quality are needed in order to draw more incisive conclusions. PROSPERO registration number CRD42020148650.
format	article
author	Luis Fernando Sousa Filho Marta Maria Barbosa Santos Gabriel Henrique Freire dos Santos Walderi Monteiro da Silva Júnior
author_facet	Luis Fernando Sousa Filho Marta Maria Barbosa Santos Gabriel Henrique Freire dos Santos Walderi Monteiro da Silva Júnior
author_sort	Luis Fernando Sousa Filho
title	Corticosteroid injection or dry needling for musculoskeletal pain and disability? A systematic review and GRADE evidence synthesis
title_short	Corticosteroid injection or dry needling for musculoskeletal pain and disability? A systematic review and GRADE evidence synthesis
title_full	Corticosteroid injection or dry needling for musculoskeletal pain and disability? A systematic review and GRADE evidence synthesis
title_fullStr	Corticosteroid injection or dry needling for musculoskeletal pain and disability? A systematic review and GRADE evidence synthesis
title_full_unstemmed	Corticosteroid injection or dry needling for musculoskeletal pain and disability? A systematic review and GRADE evidence synthesis
title_sort	corticosteroid injection or dry needling for musculoskeletal pain and disability? a systematic review and grade evidence synthesis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/7dbe128df2b048ec8363c7fb63334680
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Corticosteroid injection or dry needling for musculoskeletal pain and disability? A systematic review and GRADE evidence synthesis

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