Clinical efficacy of different needling manipulations in treatment of myofascial pain syndrome

Zhen Ci Yan Jiu. 2026 Feb 25;51(2):210-218. doi: 10.13702/j.1000-0607.20241246.

ABSTRACT

OBJECTIVES: To observe the efficacy of different needle manipulation techniques at myofascial trigger points (MTrPs) in treating myofascial pain syndrome (MPS) and to determine which technique is more advantageous.

METHODS: A total of 108 MPS patients were randomly divided into a twisting group (36 cases, with 5 dropouts), a lifting-thrusting group (36 cases, with 3 dropouts), and a non-manipulation group (36 cases, with 6 dropouts). The twisting group and lifting-thrusting group received twisting or lifting-thrusting techniques for 1 min at MTrPs, respectively, while the non-manipulation group retained the needles without manipulation for 1 min. Treatments were administered every other day, totaling 3 sessions. Before and after the first treatment and after the final treatment, patients completed the short-form McGill pain questionnaire (SF-MPQ), including the pain rating index (PRI), visual analog scale (VAS), and present pain intensity (PPI) scores. Young's modulus values at MTrPs were measured using ultrasound elastography before and after treatment. The Massachusetts acupuncture sensation scale (MASS) was used during each treatment to record the types and intensity of needling sensations. Clinical efficacy was evaluated after the final treatment.

RESULTS: After the final treatment, SF-MPQ, PRI, VAS, PPI scores, and Young's modulus values decreased (P<0.05) in all the 3 groups compared to pretreatment. After treatment, the twisting and lifting-thrusting groups showed greater reductions in SF-MPQ, PRI, PPI scores, and Young's modulus values (P<0.05) compared to the non-manipulation group, while the lifting-thrusting group had lower VAS scores (P<0.05) than the non-manipulation group. The lifting-thrusting group exhibited higher frequencies of twitching sensations and greater distension intensity (P<0.05) than the non-manipulation group. Both the twisting and lifting-thrusting groups had higher mean needling sensation intensity of twitching sensations, needle grasp (practitioner's sense of tightness), and MASS values (P<0.05) than the non-manipulation group. The total effective rates were 80.65% (25/31) in the twisting group, 84.85% (28/33) in the lifting-thrusting group, and 66.67% (20/30) in the non-manipulation group, with the lifting-thrusting group showing higher efficacy than the non-manipulation group (P<0.05). Pain relief was positively correlated with the occurrence of twitching sensations and needle grasp (P<0.01), as well as with the intensity of distension, twitching sensations, MASS values, and needle grasp (P<0.01).

CONCLUSIONS: Both twisting and lifting-thrusting techniques at MTrPs yield better clinical outcomes for MPS than non-manipulation, with the lifting-thrusting technique demonstrating superior overall efficacy. The lifting-thrusting technique is more advantageous than twisting in eliciting twitching sensations during MTrP acupuncture.

PMID:41735069 | DOI:10.13702/j.1000-0607.20241246