Effects of Dry Needling on Latent Myofascial Trigger Points of the Extensor Digitorum Communis

NCT07672093 | Recruiting

• 1 other identifier: 06/2026
• Study Type: interventional
• Target: 150
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized single-blind clinical trial aims to compare the effects of different dry needling and electrical dry needling techniques applied to latent myofascial trigger points in the extensor digitorum muscle of the dominant forearm in healthy adults. Participants will be randomly allocated to one of five groups: a control group, a Hong fast-in and fast-out dry needling group, a rotational dry needling group, a bipolar electrical dry needling group, or a monopolar electrical dry needling group. The main outcomes will be post-needling soreness intensity and duration. Secondary outcomes will include pain during the needling procedure, pressure pain threshold assessed by algometry, handgrip strength, range of motion of finger flexion and wrist palmar flexion, perceived comfort during the intervention, and perceived interference of post-needling soreness with daily activities. Assessments will be performed at baseline, 5 minutes after the intervention, and at 24, 48, and 72 hours after the intervention.

Conditions

Dry Needling Technique; Trigger Point Pain; Physical Therapy

Keywords

dry needling; latent trigger point; physical therapy

Outcome Measures

Primary Outcomes (1)

• Post-needling soreness intensity

  Post-needling soreness intensity will be assessed using a numerical pain rating scale. Participants will rate the intensity of local soreness perceived in the needling area, clearly differentiated from any other type of pain. Higher scores indicate greater pain intensity.

  1 week

Secondary Outcomes (5)

• Duration of post-needling soreness

  1 week

• Pain during needling

  Immediately after the intervention

• Pressure pain threshold

  1 week

• Handgrip strength

  1 week

• Range of motion of finger flexion and wrist palmar flexion

  1 week

Study Arms (5)

No Intervention: Control Group

NO INTERVENTION

Participants allocated to the control group will not receive any dry needling or electrical dry needling intervention. Outcome variables will be recorded following the same assessment schedule as in the intervention groups.

Experimental: Hong Fast-In and Fast-Out Dry Needling Group

EXPERIMENTAL

Participants allocated to this group will receive dry needling using the fast-in and fast-out technique described by Hong, applied to a latent myofascial trigger point in the extensor digitorum muscle of the dominant forearm.

Other: Hong fast-in and fast-out dry needling

Experimental: Rotational Dry Needling Group

EXPERIMENTAL

Participants allocated to this group will receive dry needling using a rotational technique applied to a latent myofascial trigger point in the extensor digitorum muscle of the dominant forearm.

Other: Rotational dry needling

Experimental: Bipolar Electrical Dry Needling Group

EXPERIMENTAL

Participants allocated to this group will receive bipolar electrical dry needling applied to a latent myofascial trigger point in the extensor digitorum muscle of the dominant forearm.

Other: Bipolar electrical dry needling

Experimental: Monopolar Electrical Dry Needling Group

EXPERIMENTAL

Participants allocated to this group will receive monopolar electrical dry needling using a Pointer device, applied to a latent myofascial trigger point in the extensor digitorum muscle of the dominant forearm.

Other: Monopolar electrical dry needling

Interventions

Hong fast-in and fast-out dry needling OTHER

The skin will be disinfected with 0.5% alcoholic chlorhexidine. With the participant in supine position, a sterile needle will be inserted into the latent myofascial trigger point of the extensor digitorum muscle. Once the needle has reached the trigger point, 10 fast-in and fast-out movements will be performed. The number of local twitch responses will be recorded.

Experimental: Hong Fast-In and Fast-Out Dry Needling Group

Rotational dry needling OTHER

The skin will be disinfected with 0.5% alcoholic chlorhexidine. With the participant in supine position, a sterile needle will be inserted into the latent myofascial trigger point of the extensor digitorum muscle. Once the needle has reached the trigger point, the rotational dry needling technique will be applied according to the predefined study protocol.

Experimental: Rotational Dry Needling Group

Bipolar electrical dry needling OTHER

The skin will be disinfected with 0.5% alcoholic chlorhexidine. With the participant in supine position, a sterile needle will be inserted into the latent myofascial trigger point of the extensor digitorum muscle. Once a local twitch response has been obtained, the needle will remain inserted and will act as the negative pole. An adhesive electrode connected to the positive pole will be placed approximately one centimeter from the needle. A TENS current will be applied for 15 minutes at a frequency of 2 Hz and a pulse width of 120 milliseconds. The intensity will be increased until visible, non-painful contractions of the extensor digitorum muscle are achieved.

Experimental: Bipolar Electrical Dry Needling Group

Monopolar electrical dry needling OTHER

The skin will be disinfected with 0.5% alcoholic chlorhexidine. With the participant in supine position, a sterile needle will be inserted into the latent myofascial trigger point of the extensor digitorum muscle. Once a local twitch response has been obtained, the needle will remain inserted in the trigger point. The metallic tip of the Pointer Plus Excel-II device will be placed in contact with the needle, and a TENS current will be applied for 3 minutes at a frequency of 2 Hz and a pulse width of 220 milliseconds. The intensity will be increased until visible, non-painful contractions of the extensor digitorum muscle are achieved.

Experimental: Monopolar Electrical Dry Needling Group

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Adults aged 18 to 40 years.
• Healthy participants with a latent myofascial trigger point in the extensor digitorum muscle of the dominant forearm.
• No pathology affecting the upper limb where the intervention will be applied.
• No episode of pain in the upper limb during at least the previous two months.
• No contraindications to dry needling or electrical dry needling techniques.
• Voluntary signature of the informed consent form.
• Willingness to follow the protocol proposed by the research team.

You may not qualify if:

• Needle phobia.
• Coagulation disorders.
• Pregnancy.
• Thyroid disorders.
• Altered skin integrity in the treatment area.
• Epilepsy.
• Local or systemic infection.
• Diagnosed neurological disorders affecting pain perception or neuromuscular function in the region of interest, such as multiple sclerosis or peripheral neuropathies.
• Generalized chronic pain conditions, such as fibromyalgia.
• Weekly use of analgesic medication, including anti-inflammatory drugs, opioids, or other pain-relieving medication.

Sponsors & Collaborators

• University Rovira i Virgili: lead

Study Sites (1)

Facultat de Medicina i Ciències de la Salut

Reus, Tarragona, 43203, Spain

RECRUITING

Related Publications (8)

• Gallagher EJ, Liebman M, Bijur PE. Prospective validation of clinically important changes in pain severity measured on a visual analog scale. Ann Emerg Med. 2001 Dec;38(6):633-8. doi: 10.1067/mem.2001.118863.

  PMID: 11719741 BACKGROUND

• Kalichman L, Vulfsons S. Dry needling in the management of musculoskeletal pain. J Am Board Fam Med. 2010 Sep-Oct;23(5):640-6. doi: 10.3122/jabfm.2010.05.090296.

  PMID: 20823359 BACKGROUND

• Fernandez-de-Las-Penas C, Dommerholt J. International Consensus on Diagnostic Criteria and Clinical Considerations of Myofascial Trigger Points: A Delphi Study. Pain Med. 2018 Jan 1;19(1):142-150. doi: 10.1093/pm/pnx207.

  PMID: 29025044 BACKGROUND

• Perreault T, Ball A, Dommerholt J, Theiss R, Fernandez-de-Las-Penas C, Butts R. Intramuscular Electrical Stimulation to Trigger Points: Insights into Mechanisms and Clinical Applications-A Scoping Review. J Clin Med. 2022 Oct 13;11(20):6039. doi: 10.3390/jcm11206039.

  PMID: 36294360 BACKGROUND

• Leon-Hernandez JV, Martin-Pintado-Zugasti A, Frutos LG, Alguacil-Diego IM, de la Llave-Rincon AI, Fernandez-Carnero J. Immediate and short-term effects of the combination of dry needling and percutaneous TENS on post-needling soreness in patients with chronic myofascial neck pain. Braz J Phys Ther. 2016 Jul 11;20(5):422-431. doi: 10.1590/bjpt-rbf.2014.0176.

  PMID: 27410163 BACKGROUND

• Martin-Pintado-Zugasti A, Mayoral Del Moral O, Gerwin RD, Fernandez-Carnero J. Post-needling soreness after myofascial trigger point dry needling: Current status and future research. J Bodyw Mov Ther. 2018 Oct;22(4):941-946. doi: 10.1016/j.jbmt.2018.01.003. Epub 2018 Jan 17.

  PMID: 30368339 BACKGROUND

• Brady S, McEvoy J, Dommerholt J, Doody C. Adverse events following trigger point dry needling: a prospective survey of chartered physiotherapists. J Man Manip Ther. 2014 Aug;22(3):134-40. doi: 10.1179/2042618613Y.0000000044.

  PMID: 25125935 BACKGROUND

• Hong CZ. Lidocaine injection versus dry needling to myofascial trigger point. The importance of the local twitch response. Am J Phys Med Rehabil. 1994 Jul-Aug;73(4):256-63. doi: 10.1097/00002060-199407000-00006.

  PMID: 8043247 BACKGROUND

Study Officials

• Tania López Hernández

  Unviersitat Rovira i Virgili

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Tania López Hernández, Phd

CONTACT

34+620438175; tania.lopez@urv.cat

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The study was conducted using a single-blind design. The researchers responsible for recruitment and assessments were unaware of each participant's intervention group, which helped reduce detection bias. Data analysis will be performed by an external researcher. The principal investigator will manage the study documentation, informed consent process, and randomization. Double blinding was not possible because the intervention involved invasive physical techniques, including dry needling and electrical dry needling. Therefore, participants could perceive differences between the procedures and were aware of whether they received an intervention or were allocated to the control group.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: June 22, 2026
• First Posted: June 26, 2026
• Study Start: July 1, 2026
• Primary Completion: August 1, 2026
• Study Completion: August 1, 2026
• Last Updated: July 1, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

ES (1)