Dry Needling for Patellofemoral Pain

Data from a recent study reveals that PF pain has a prevalence of 43% in the general population. It is seen from the study as an integral part of the multifactorial pain concept. Further studies are needed to clarify its pathogenesis.

Pain from the patella is very common. The pain typically starts during adolescence. The pain rarely resolves; however, the patella may heal when the pain improves. Pain is usually caused by small tears in the patellar tendon.

It is unclear why PFP has a gender disparity, but it is thought its onset can occur after a knee injury. The pain is thought to originate from the patellar tendon and is therefore thought to result from overuse. There is only moderate to good evidence to support the use of a brace or a splint in the conservative management of knee pain after a positive McMurry line. There is no evidence to support the use of a joint hypermobility syndrome, massage therapy, steroid injections, or ultrasound therapy. There is limited evidence that suggests exercises can be used to manage discomfort of the patellar tendon and that the patella can be manipulated to reduce the discomfort during activity.

About 42 million Americans have PFOP at some point in their lives. There will be an estimated 40 million new cases of PFOP in the United States a year.

While a vast majority of patients presenting to physical rehabilitation centres have some improvement, there is no statistically significant difference in the outcome between those who were originally diagnosed with patellofemoral pain and those with femorotibial osteoarthritis. There is, however, a significant difference in the improvement in symptoms in the patients who had an arthroscopic debridement with or without osteoplasty. Patellofemoral pain should therefore be regarded as an initial presentation of patella baja. A diagnosis of true or pseudo-patella baja should be made when possible and patella baja should be carefully monitored.

Given the lack of evidence that any specific non-steroidal anti-inflammatory (NSAID) can replace acetaminophen in alleviating patellofemoral pain, we argue that other non-traditional treatments for patellofemoral pain such as eccentric exercise, proprioception training, eccentric endurance, and stretching in order to avoid over-flexion and abduction strengthening should be more studied and discussed more widely in order to relieve the patellofemoral pain.

Overall, we found no evidence that dry needling is better or worse than placebo in improving pain, function or health-related quality of life in patients with Patellofemoral Pain Syndrome during the short term.

In recent years, dry needling has been a popular technique in a wide range of medical institutions in various parts of the world. This popular technique is most common in China with a variety of applications such as treatment of chronic pain for orthopaedic and soft tissue disorders. However, in spite of the large number of studies done on dry needling, there have not been studies done on their specific mechanisms of action, no controlled trials, and some of their therapeutic effects have been shown to be ineffective, based on the results of these studies. There is a limitation of our study that the number of study groups was small (n = 2).

Although the [knee pain](https://www.withpower.com/clinical-trials/knee-pain) from patellofemoral pain is most intense when suddenly kneeling or walking, most of those with patellofemoral pain are symptomatic while sitting or standing. This suggests that patellofemoral pain is not a good surrogate indicator of patellofemoral subchondral damage. The patellar baja deformity is also uncommon in people with patellojejunal pain and should not be used as a screening test for subchondral bony lesions.

While dry needling showed increased efficacy relative to placebo for relieving pain, it was less effective than acupuncture. In addition, increased pain ratings were greater in the dry needling group. Recent findings suggest that dry needling is more likely to be more effective than acupuncture to relieve pain, and more likely to generate elevated pain scores for people with fibromyalgia. Further research is required into these findings.