Effectiveness of dry needling and intramuscular electrical stimulation in managing musculoskeletal pain: a systematic review

Abstract

Background: Myofascial Pain Syndrome (MPS) is a chronic pain condition affecting muscles and fascia. Pressure on affected areas causes localized or referred pain. MPS contributes significantly to the global disease burden, especially among working-age adults, reducing physical performance and quality of life. Despite its prevalence, MPS is often underdiagnosed and undertreated, highlighting the need for effective management. This review focuses on the effectiveness of dry needling (DN) for MPS, particularly when combined with other therapies such as intramuscular electrical stimulation (IMES) and trigger point compression.

Methods: We searched PubMed, Science Direct, Sage Journals, Scopus and Google Scholar for this review. We included English-language articles published between 2013 and 2024. Search keywords included "Myofascial Pain Syndrome," "Dry Needling," "Trigger Points," "Electrical Stimulation," "Pain Management," and "Muscle Pain." Reference lists of selected papers were manually screened for additional relevant studies.

Results: Findings indicate that DN, both alone and combined with other treatments (IMES, trigger point compression), significantly reduces pain in MPS. Mean VAS reduction was 3.2 points, and NRS reduction was 2.5 points in some studies. Improvements in patient mobility were also reported with DN and other techniques. Combining DN with IMES provided greater and more sustained pain relief, particularly in adhesive capsulitis and fibromyalgia.

Conclusion: Dry needling, especially when combined with IMES, appears highly effective for pain relief and mobility improvement in MPS patients. This combined approach shows clear advantages over other treatments. Future research should establish standardized protocols and evaluate long-term benefits.