645 - Efficacy of Various Modalities (Dry Needling, Myofascial Release, Lidocaine Injections, and Corticosteroid Injections) on Myofascial Trigger Points: A Systematic Review and Meta-Analysis

A systematic review and random effects meta analysis was performed following PRISMA guidelines. Databases Embase, PubMed, Scopus, Google Scholar, and Cochrane, were searched using a boolean string following set inclusion/exclusion criteria for DN, MFR, LI, corticosteroids (yielded insufficient results, and subsequently excluded from quantitative analysis), and related terms. Data was collected on Visual Analog Scale (VAS)/Numeric Pain Rating Scale (NPRS) scores before and after treatment.

Results: Pain outcomes for MTrP were compared between dry needling, lidocaine, and MFR. Significant differences compared to baseline were found for DN (p < 0.01, Cohen’s D = -1.89 [-2.87, -1.40]) and MFR (p < 0.01, Cohen’s D = -2.84 [-4.02, -1.67]) but not for LI (p = 0.51, Cohen’s D = -9.62, 0.03]). Heterogeneity, represented by I2, was 90.7%, 99.2%, and 92.8% for DN, LI, and MFR groups respectively.

Conclusions:

Individually, trends suggest that all three modalities are effective for reducing pain in symptomatic MTrP, with LI showing the greatest effect size. DN and MFR had a greater impact on reducing mean VAS pain scores, with lower heterogeneity, indicating they may be more reliable methods for managing MTrP. In conclusion, this systematic review was conducted to juxtapose the benefits of various modalities on MTrP. While LI had the highest effect size, there was no significant difference in pain reduction from baseline when compared to other modalities. DN and MFR showed significant pain reduction but had lower effect sizes.