Adding trigger point dry needling (TrP-DN) to an exercise program may be more effective than exercise alone for lowering costs associated with subacromial pain syndrome care, according to a randomized clinical trial published in Pain Medicine.
Dry needing consists of inserting a thin filiform needle into the skin to stimulate trigger points, muscles, and connective tissue, and is used as an adjunct to exercise.
In this study, patients with unilateral subacromial pain syndrome were assigned to follow an exercise-only regimen (n=25) or exercise plus TrP-DN (n=25). The exercise program consisted of twice-daily exercise, focusing on the rotator cuff musculature, for a total of 5 weeks.
Dry needling was performed during the third and fourth sessions in patients assigned to the exercise plus TrP-DN group. Societal costs, costs associated with treatment, and participants’ health-related quality of life were evaluated over a 1-year follow-up period to determine incremental cost per quality-adjusted life-year ratios.
Compared with patients receiving TrP-DN plus exercise, participants performing exercise only required a greater number of doctor visits and treatments (P <.001), as well as higher societal costs, largely resulting from absenteeism from paid labor (77%; P =.03). In addition, combining exercise with TrP-DN was less costly overall than exercise only (P =.003) and had a greater benefit on incremental quality-adjusted life-years (95% CI, 2.85-2.89).
This study did not include a control group and therefore does not allow to determine whether the addition of TrP-DN to exercise provides superior benefit compared with no treatment.
Also, patient data were obtained from a Spanish healthcare system, and the investigators suggest that the findings from this study may not generalize to patients residing in other geographic areas.
“Future studies should examine the cost-effectiveness of commonly used interventions for the management of shoulder pain, including TrP-DN combined with other interventions,” concluded the study authors.
Arias-Buría JL, Martín-Saborido C, Cleland J, et al. Cost-effectiveness evaluation of the inclusion of dry needling into an exercise program for subacromial pain syndrome: evidence from a randomized clinical trial [published online February 22, 2018]. Pain Med. doi: 10.1093/pm/pny021