Dry Needling and Pain Drawings: An Exploratory Study

Background: Emerging evidence shows that altered cortical brain maps play a key role in the initiation and maintenance of a human pain experience and therapeutic treatments may positively influence these maps and reduce pain and disability. Objective: To determine if dry needling for spinal pain can positively alter body pain diagrams and if those changes correlate to a reduction in self-reported pain ratings. Design: Case series with pre- and immediate post-intervention measurements. Methods: A convenience sample of adult patients attending physical therapy with back or neck pain meeting inclusion criteria for dry needling was recruited for the study. Prior to dry needling, patients completed a demographics questionnaire, filled in a body pain diagram (color where you hurt) and a self-reported pain rating (numeric pain rating scale). Patients then received a standard dry needling session for the affected area and immediately following dry needling completed a body pain diagram, self-reported pain rating and satisfaction with the treatment using the global rating of change scale. Results: Forty-three patients (76.74% female) participated in the study with 19 patients presenting with low back pain and 24 with neck pain. Following dry needling, mean pain rating for the whole cohort was reduced (p<0.001), with larger effect for low back pain (p < 0.001) than neck pain (p = 0.031). Overall, the whole patient sample's body pain diagram decreased in size by 50.16% following DN (95%CI = 10.8, 22.6; t(42)=5.67, p < 0.001). When broken down between neck and low back pain, low back maps shrunk by 61.84% (95%CI= 16.1 - 38.6), t(18)=5.1, p < 0.001), whereas neck maps decreased by 33% (95%CI= 4.3 - 12.2, t(23)=4.4, p < .001). Positive correlations were found between the size of the body pain drawings and pain intensity (rs = 0.461 (p = 0.002) as well as reduction of pain after dry needling and reduction in body map drawings (rs = 0.305 (p = 0.047). Conclusion: Dry needling can reduce body map drawings, which correlates to the intensity of pain. A potential underlying mechanism of dry needling may be its effect on neuroplasticity. Additional research is needed to further explore these emerging results