Trigger point dry needling as an adjunct treatment for a patient with adhesive capsulitis of the shoulder
In this case report, the authors describe the treatment of a 54-year-old woman with stage 2 adhesive capsulitis. Initially – due to a high local tissue-irritability that did not allow local joint mobilizations – a regional-interdependent approach of thrust mobilizations and self-mobilizing exercises for the cervicothoracic spine was used. This, however, resulted in only marginal improvements in pain and ROM.
Subsequently, as an alternative treatment modality, DN was performed on active trigger points in the upper trapezius, levator scapulae, infraspinatus and deltoid muscles. This led to marked improvements in pain and ROM – on the QuickDASH and SPADI scores the improvement exceeded the minimal clinically important difference.
Trigger point DN in this specific case served as an adjunct treatment creating the optimal conditions for higher-grade joint mobilizations to be tolerated by the patient and to be effective. Nevertheless, although these findings are promising and identify DN as a possible effective treatment modality in adhesive capsulitis, higher-level research is needed to confirm the effects of DN and improve generalizability. > From: Clewley et al., J Orthop Sports Phys Ther 44 (2014) 92-101. All rights reserved to the Journal of Orthopaedic & Sports Physical Therapy.
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