Wednesday, March 21, 2018 Study: Adding Dry Needling to Exercise for Shoulder Pain Could Reduce Broader Costs Adding trigger point dry needling to an exercise program for patients with chronic shoulder pain may be more cost-effective than exercise alone, according to a recent clinical trial. The combined intervention led to “improved quality of life and lower…costs than exercise alone,” write authors in Pain Medicine (abstract-only available for free). The study is an expansion of earlier published results of the trial, which indicated that including trigger point dry needling was just as effective as exercise alone at reducing shoulder pain intensity, and better at improving pain-related disability. That open-access article appears in The Journal of Pain. Researchers recruited 50 participants with unilateral shoulder pain lasting more than 3 months from a hospital in Madrid, Spain. All patients had been diagnosed with subacromial pain syndrome and had no history of shoulder or neck injury, cervical radiculopathy, fibromyalgia, shoulder or neck surgery, shoulder steroid injections, or any type of shoulder or neck intervention. Patients were randomly assigned to 1 of 2 groups; both groups received treatment once per week for 5 weeks. Both groups received a supervised, clinical practice guideline-based exercise program of 3 exercises targeting the supraspinatus, infraspinatus, and scapular stabilizer musculature. The second also received trigger point dry needling on the second and fourth sessions. Authors analyzed societal costs and measured health-related quality of life during the 12-month follow-up period. Here’s what they found: Direct health care costs. Patients in the exercise-only group made more visits to their physicians. They also received more supplemental treatments, such as cold packs and extra physical therapy sessions, compared with the exercise plus trigger point dry needling group. Indirect costs of lost productivity. Work absenteeism and average cost of absenteeism were significantly higher for patients in the exercise-only group. Quality of life. Patients who also received trigger point dry needling “reported significantly better quality of life” compared with those who only received exercise. Cost-effectiveness. Exercise plus trigger point dry needling was “more likely to be cost-effective” than exercise alone. The greatest cost savings, say researchers, came from lower work absenteeism in the trigger point dry needling group. While authors acknowledge that the study results do not necessarily apply to other countries, they suggest “these differences would not alter the direction of current results.” Authors of the study include APTA members Joshua Cleland, PT, DPT; and Shane Koppenhaver, PT, PhD. Both Cleland and Koppenhaver are board-certified orthopaedic clinical specialists and fellows of the American Academy of Manual Physical Therapy. Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.