Comparison of Post-needling Soreness among Three Soreness Reduction Methods: Diclofenac spray with Contract-Relax Stretching, Cold Gel Pack with Self Stretching, and Spray and Stretch Technique in Patients after Upper Trapezius Dry Needling
Triluk Vorawanthanachai
Department of Rehabilitation Medicine, Phetchabun Hospital, Phetchabun 67000, Thailand; Email: [email protected]
 Objectives: To compare post-needling soreness among three different soreness reduction methods: diclofenac spray with contract-relax stretching, cold gel pack with self-stretching, and spray and stretch technique in patients after upper trapezius dry needling.
Study design: A randomized controlled trial.
Setting: Department of Rehabilitation Medicine, Phetchabun Hospital, Phetchabun Province, Thailand.
Subjects: One hundred and twenty-six participants who had a numeric rating scale (NRS) score of post-needling soreness intensity of 3 or more and who received dry needling as a treatment of myofascial pain syndrome at the upper trapezius.
Methods: Participants were allocated into three groups (42 patients per group) which received different soreness reduction methods: a cold gel pack combined with self-stretching (CP group), a diclofenac spray combined with contract-relax stretching (DCF group), and a spray and stretch technique (SS group). The primary outcome was the post-needling soreness numeric rating scale score. Secondary outcomes were muscle pain NRS and pain-free cervical range of motion (ROM).
Results: No statistically significant difference (p > 0.05) among the dependent variables, including post-needling soreness, muscle pain, and pain-free forward neck flexion, was observed among the 3 groups with the exception of pain-free lateral neck flexion which was greater in the DCF and SS group. Pairwise analyses demonstrated that the DCF and SS groups both had significantly greater post-needling soreness reduction immediately after the treatment when compared with the CP group (DCF = -1.9, SS = -1.5, CP = -0.7) and also 24 hours after dry needling (DCF = -2.6, SS = -2.1, CP = -1.3).
Conclusions: DCF spraying with contract-relax stretching can reduce post-dry needling soreness at the upper trapezius muscle at a level comparable to the spray and stretch technique. Both methods were superior to cold gel packs with self-stretching. In addition to the spray and stretch techniques, DCF spraying with
 contract-relax stretching might be the intervention of choice to effectively reduce post-dry needling soreness at the upper trape-zius muscle.
เวชศาสตร์ฟื้นฟูสาร ปี 2565, May-August ปีที่: 33 ฉบับที่ 2 หน้า 63-74
Upper trapezius, cold gel pack, post-needling soreness, spray and stretch technique, diclofenac spray