The role of psychological factors on the perception of postneedling soreness and the influence of postneedling intervention.

PM R. 2016 Aug 1;

Authors: Martín-Pintado-Zugasti A, López-López A, González Gutiérrez JL, Pecos-Martín D, Rodríguez-Fernández ÁL, Alguacil-Diego IM, Gallego-Izquierdo T, Fernández-Carnero J

Abstract
BACKGROUND: Myofascial trigger point dry needling is frequently associated with postneedling soreness, which can generate patient dissatisfaction and reduced treatment adherence. Psychological factors may influence the perception of postneedling soreness and the effectiveness of postneedling soreness treatments.
OBJECTIVES: The objectives of the present study were (a) to determine whether catastrophizing, kinesiophobia, pain anxiety and fear of pain are significant predictors of postneedling soreness over time and (b) to analyze if the relationships between psychological variables and postneedling soreness vary as a function of the postneedling soreness intervention, which included ischemic compression, placebo or control (without treatment).
DESIGN: Repeated-measures observational study nested within a randomized controlled trial.
SETTING: University community.
PARTICIPANTS: Healthy volunteers (N=90:40 men,50 women) aged 18 to 39 years (mean±SD,22±3y).
METHODS: Catastrophizing, kinesiophobia, pain anxiety and fear of pain were evaluated as possible predictors of postneedling pain before dry needling in a latent myofascial trigger point in the upper trapezius muscle. Then, participants were divided into a treatment group that received ischemic compression as a postneedling intervention, a placebo group that received sham ischemic compression and a control group without treatment.
MAIN OUTCOME MEASUREMENTS: Pain during needling and postneedling soreness were quantified using a visual analog scale during needling, after treatment, and at 6, 12, 24, and 48 hours.
RESULTS: A multilevel analysis revealed that people who exhibited more catastrophic thinking showed less postneedling soreness intensity immediately after needling in all subjects (β=-.049). Pain-related anxiety was linked to higher immediate postneedling soreness in the compression condition (β =.057). Finally, people who exhibited more catastrophic thinking showed a slower rate of decline in postneedling soreness levels over time in the compression condition(β = .038).
CONCLUSIONS: Catastrophizing was associated with lower levels of postneedling soreness immediately after needling in all subjects. While ischemic compression seems to be a useful procedure to reduce postneedling soreness, its efficacy could be slightly reduced in patients presenting higher scores of pain-related anxiety. Psychological procedures may help to correct the distorted pain expectancies associated with needling interventions and might also improve the effectiveness of ischemic compression.

PMID: 27492276 [PubMed – as supplied by publisher]