Hall ML, et al. – This systematic review aimed to investigate the effectiveness and adverse effects of trigger point dry needling (TDN) for the management of upper extremity pain or dysfunction. For treating patients with upper extremity pain or dysfunction, there was very low evidence to support the use of TDN in the shoulder region. 2 studies reported adverse effects to TDN interventions. The most common adverse effects were bruising, bleeding, and pain during or after treatment. For patients with upper extremity pain or dysfunction, future studies were likely to change the estimates of the effectiveness of TDN.

• The authors included patients with shoulder or upper extremity pain or dysfunction.
• To control upper extremity pain and dysfunction, they compared TDN with another intervention or another needling technique.
• Shoulder or upper limb pain, shoulder or upper limb dysfunction were included as primary outcome measures.

• The authors evaluated 11 randomized trials involving 496 participants.
• The study found very low evidence that trigger point dry needling of the shoulder region was effective for reducing pain and improving function in the short term.
• There was some evidence that compared to needling the active trigger point alone, needling both active and latent trigger points was more effective for pain immediately and 1-week after treatment (SMD = -0.74, 95%CI = -1.2 to -0.3; and SMD = -1.0, 95%CI = -1.52 to -0.59).
• For reducing pressure threshold of anterior deltoid immediately and 1-week after treatment, needling the active trigger point was more effective than needling both active and latent trigger points (SMD = 0.9, 95%CI = 0.4 to 1.3; and SMD = 1.0, 95%CI = 0.55 to 1.48).