Article Text

Effectiveness of dry needling of rectus abdominis trigger points for the treatment of primary dysmenorrhoea: a randomised parallel-group trial
  1. Alberto Gaubeca-Gilarranz1,
  2. César Fernández-de-las-Peñas2,3,
  3. José Raúl Medina-Torres1,
  4. José M Seoane-Ruiz4,
  5. Aurelio Company-Palonés1,
  6. Joshua A Cleland5,6,7,
  7. Jose L Arias-Buría2,3
  1. 1Universidad de Alcalá de Henares, Alcalá de Henares, Spain
  2. 2Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcon, Spain
  3. 3Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
  4. 4Hospital Universitario 12 de Octubre, Madrid, Spain
  5. 5Department of Physical Therapy, Franklin Pierce University, Manchester, New Hampshire, USA
  6. 6Physical Therapist, Rehabilitation Servicesv, Concord Hospital, Concord, New Hampshire, USA
  7. 7Faculty, Manual Therapy Fellowship Program, Regis University, Denver, Colorado, USA
  1. Correspondence to Dr César Fernández-de-las-Peñas, Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcon 28922, Madrid, Spain; cesarfdlp{at}


Objective To compare the effectiveness of trigger point dry needling (TrP-DN) versus placebo needling, relative to an untreated control group, on pain and quality of life in primary dysmenorrhoea.

Methods In this randomised, single blind, parallel-group trial, 56 females with primary dysmenorrhoea were randomly allocated to TrP-DN (n=19), placebo needling (n=18) or no treatment (n=19). Patients in both groups were asked to undertake a stretching exercise of the rectus abdominis daily. The needling group received a single session of TrP-DN to trigger points (TrPs) in the rectus abdominis, and the placebo group received placebo needling. The primary outcome was pain intensity (visual analogue scale). Secondary outcomes were quality of life, use of non-steroidal anti-inflammatory drugs, the number of days with pain, and self-perceived improvement, measured using a Global Rate of Change. Outcomes were assessed at baseline, and 1 and 2 months after the treatment.

Results Females receiving TrP-DN exhibited greater decreases (P<0.001) in pain than those receiving placebo (1 month: Δ−19.8 mm, 25.9 to −13.7; 2 months: Δ−26.0 mm, −33.1 to −18.9) or assigned to the untreated control group (1 month: Δ−26.0mm, −32.5 to −19.5; 2 months: Δ−20.1 mm, −26.4 to −13.8). Females in the TrP-DN group also exhibited a greater decrease in the amount of medications (P<0.001). No differences in the number of days with pain or quality of life were found (all P>0.1).

Conclusions This trial suggests that a single session of TrP-DN of the rectus abdominis combined with stretching was more effective than placebo needling and stretching alone at reducing pain and the amount of medication used in primary dysmenorrhoea.

Trial registration number ACTRN12616000170426.

  • acupuncture
  • myofascial pain
  • pain management

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  • Contributors All authors contributed to the study concept and design. AGG, CFdlP and JLAB did the main statistical analysis. JRMT, JMSR and ACP contributed to the literature review and interpretation of the data. CFdlP and JAC contributed to the drafting of the report. JAC and JAB provided administrative, technical and material support. JAC and JLAB supervised the study. All authors revised the text for intellectual content, and read and approved the final version of the manuscript accepted for publication.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval Universidad de Alcalá, Spain (CEIM/HU/2015/22)

  • Provenance and peer review Not commissioned; externally peer reviewed.

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