Original Article| Volume 35, ISSUE 9, P685-691, November 2012

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The Influence of Dry Needling of the Trapezius Muscle on Muscle Blood Flow and Oxygenation



      The purpose of this study was to investigate the effect of dry needling on the blood flow and oxygen saturation of the trapezius muscle.


      Twenty healthy participants participated in this study. One single dry needling procedure was performed in the right upper trapezius, at a point located midway between the acromion edge and the seventh cervical vertebrae. Using the oxygen to see device, blood flow and oxygen saturation were evaluated at the treated point and 3 distant points (similar point in the left upper trapezius and 30 mm laterally from this midpoint). Measurements were taken at baseline and in the recovery period (0, 5, and 15 minutes posttreatment).


      After removal of the needle, the blood flow and oxygen saturation increased significantly from the pretreatment level in the treated point (P ≤ .001), and these values remained high throughout the 15-minute recovery period. There were only minor changes in the distant points.


      These results suggest that dry needling enhances the blood flow in the stimulated region of the trapezius muscle but not in a distant region used in this study.

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        • Aguilera FJ
        • Martin DP
        • Masanet RA
        • Botella AC
        • Soler LB
        • Morell FB
        Immediate effect of ultrasound and ischemic compression techniques for the treatment of trapezius latent myofascial trigger points in healthy subjects: a randomized controlled study.
        J Manipulative Physiol Ther. 2009; 32: 515-520
        • Zakharova-Luneva E
        • Jull G
        • Johnston V
        • O'leary S
        Altered trapezius muscle behavior in individuals with neck pain and clinical signs of scapular dysfunction.
        J Manipulative Physiol Ther. 2012; 35: 346-353
        • Larsson B
        • Bjork J
        • Kadi F
        • Lindman R
        • Gerdle B
        Blood supply and oxidative metabolism in muscle biopsies of female cleaners with and without myalgia.
        Clin J Pain. 2004; 20: 440
        • Kadi F
        • Waling K
        • Ahlgren C
        • Sundelin G
        • Holmner S
        • Butler-Browne GS
        • et al.
        Pathological mechanisms implicated in localized female trapezius myalgia.
        Pain. 1998; 78: 191-196
        • Sjogaard G
        • Lundberg U
        • Kadefors R
        The role of muscle activity and mental load in the development of pain and degenerative processes at the muscle cell level during computer work.
        Eur J Appl Physiol. 2000; 83: 99-105
        • Gerwin RD
        • Dommerholt J
        • Shah JP
        An expansion of Simons' integrated hypothesis of trigger point formation.
        Curr Pain Headache Rep. 2004; 8: 468-475
        • Cagnie B
        • Dhooge F
        • Van AJ
        • Cools A
        • Cambier D
        • Danneels L
        Changes in microcirculation of the trapezius muscle during a prolonged computer task.
        Eur J Appl Physiol. 2012; 112: 3305-3312
        • Flodgren GM
        • Crenshaw AG
        • Gref M
        • Fahlstrom M
        Changes in interstitial noradrenaline, trapezius muscle activity and oxygen saturation during low-load work and recovery.
        Eur J Appl Physiol. 2009; 107: 31-42
        • Flodgren GM
        • Hellstrom FB
        • Fahlstrom M
        • Crenshaw AG
        Effects of 30 versus 60 min of low-load work on intramuscular lactate, pyruvate, glutamate, prostaglandin E(2) and oxygenation in the trapezius muscle of healthy females.
        Eur J Appl Physiol. 2006; 97: 557-565
        • Flodgren GM
        • Crenshaw AG
        • Hellstrom F
        • Fahlstrom M
        Combining microdialysis and near-infrared spectroscopy for studying effects of low-load repetitive work on the intramuscular chemistry in trapezius myalgia.
        J Biomed Biotechnol. 2010; 2010: 513803
        • Sjogaard G
        • Rosendal L
        • Kristiansen J
        • Blangsted AK
        • Skotte J
        • Larsson B
        • et al.
        Muscle oxygenation and glycolysis in females with trapezius myalgia during stress and repetitive work using microdialysis and NIRS.
        Eur J Appl Physiol. 2010; 108: 657-669
        • Rosendal L
        • Larsson B
        • Kristiansen J
        • Peolsson M
        • Sogaard K
        • Kjaer M
        • et al.
        Increase in muscle nociceptive substances and anaerobic metabolism in patients with trapezius myalgia: microdialysis in rest and during exercise.
        Pain. 2004; 112: 324-334
        • Gaspersic R
        • Koritnik B
        • Erzen I
        • Sketelj J
        Muscle activity–resistant acetylcholine receptor accumulation is induced in places of former motor endplates in ectopically innervated regenerating rat muscles.
        Int J Dev Neurosci. 2001; 19: 339-346
        • Dommerholt J
        • Mayoral del Moral O
        • Gröbli C
        Trigger point dry needling.
        J Man Manipulative Ther. 2006; 14: E70-E87
        • Sandberg M
        • Larsson B
        • Lindberg LG
        • Gerdle B
        Different patterns of blood flow response in the trapezius muscle following needle stimulation (acupuncture) between healthy subjects and patients with fibromyalgia and work-related trapezius myalgia.
        Eur J Pain. 2005; 9: 497-510
        • Sandberg M
        • Lundeberg T
        • Lindberg LG
        • Gerdle B
        Effects of acupuncture on skin and muscle blood flow in healthy subjects.
        Eur J Appl Physiol. 2003; 90: 114-119
        • Sandberg M
        • Lindberg LG
        • Gerdle B
        Peripheral effects of needle stimulation (acupuncture) on skin and muscle blood flow in fibromyalgia.
        Eur J Pain. 2004; 8: 163-171
        • Kubo K
        • Yajima H
        • Takayama M
        • Ikebukuro T
        • Mizoguchi H
        • Takakura N
        Effects of acupuncture and heating on blood volume and oxygen saturation of human Achilles tendon in vivo.
        Eur J Appl Physiol. 2010; 109: 545-550
        • Shah JP
        • Gilliams EA
        Uncovering the biochemical milieu of myofascial trigger points using in vivo microdialysis: an application of muscle pain concepts to myofascial pain syndrome.
        J Bodyw Mov Ther. 2008; 12: 371-384
        • Shah JP
        • Danoff JV
        • Desai MJ
        • Parikh S
        • Nakamura L
        • Phillips T
        Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points.
        Arch Phys Med Rehabil. 2008; 89: 16-23
        • Knobloch K
        • Kraemer R
        • Lichtenberg A
        • Jagodzinski M
        • Gosling T
        • Richter M
        • et al.
        Microcirculation of the ankle after Cryo/Cuff application in healthy volunteers.
        Int J Sports Med. 2006; 27: 250-255
        • Knobloch K
        • Kraemer R
        • Lichtenberg A
        • Jagodzinski M
        • Gossling T
        • Richter M
        • et al.
        Achilles tendon and paratendon microcirculation in midportion and insertional tendinopathy in athletes.
        Am J Sports Med. 2006; 34: 92-97
        • Kraemer R
        • Lorenzen J
        • Rotter R
        • Vogt PM
        • Knobloch K
        Achilles tendon suture deteriorates tendon capillary blood flow with sustained tissue oxygen saturation—an animal study.
        J Orthop Surg Res. 2009; 4: 32
        • Knobloch K
        • Grasemann R
        • Jagodzinski M
        • Richter M
        • Zeichen J
        • Krettek C
        Changes of Achilles midportion tendon microcirculation after repetitive simultaneous cryotherapy and compression using a Cryo/Cuff.
        Am J Sports Med. 2006; 34: 1953-1959
        • Ghazanfari M
        • Vogt L
        • Banzer W
        • Rhodius U
        Reproducibility of non-invasive blood flow measurements using laser Doppler spectroscopy.
        Phys Med Rehab Kuror. 2002; 12: 330-336
        • Forst T
        • Hohberg C
        • Tarakci E
        • Forst S
        • Kann P
        • Pfutzner A
        Reliability of lightguide spectrophotometry (O2C) for the investigation of skin tissue microvascular blood flow and tissue oxygen supply in diabetic and nondiabetic subjects.
        J Diabetes Sci Technol. 2008; 2: 1151-1156
        • Walter B
        • Bauer R
        • Krug A
        • Derfuss T
        • Traichel F
        • Sommer N
        Simultaneous measurement of locl cortical blood flow and tissue oxygen saturation by near infra-red laser Doppler flowmetry and remission spectroscopy in the pig brain.
        Acta Neurochir Suppl. 2002; 81: 197-199
        • Sandberg ML
        • Sandberg MK
        • Dahl J
        Blood flow changes in the trapezius muscle and overlying skin following transcutaneous electrical nerve stimulation.
        Phys Ther. 2007; 87: 1047-1055
        • Nielsen PK
        • Andersen LL
        • Olsen HB
        • Rosendal L
        • Sjogaard G
        • Sogaard K
        Effect of physical training on pain sensitivity and trapezius muscle morphology.
        Muscle Nerve. 2010; 41: 836-844
        • Heiden M
        • Lyskov E
        • Djupsjobacka M
        • Hellstrom F
        • Crenshaw AG
        Effects of time pressure and precision demands during computer mouse work on muscle oxygenation and position sense.
        Eur J Appl Physiol. 2005; 94: 97-106
        • Jensen C
        • Westgaard RH
        Functional subdivision of the upper trapezius muscle during low-level activation.
        Eur J Appl Physiol Occup Physiol. 1997; 76: 335-339
        • Sato A
        • Sato Y
        • Shimura M
        • Uchida S
        Calcitonin gene-related peptide produces skeletal muscle vasodilation following antidromic stimulation of unmyelinated afferents in the dorsal root in rats.
        Neurosci Lett. 2000; 283: 137-140
        • Holzer P
        Neurogenic vasodilatation and plasma leakage in the skin.
        Gen Pharmacol. 1998; 30: 5-11
        • Koltzenburg M
        • Handwerker HO
        Differential ability of human cutaneous nociceptors to signal mechanical pain and to produce vasodilatation.
        J Neurosci. 1994; 14: 1756-1765
        • Magerl W
        • Treede RD
        Heat-evoked vasodilatation in human hairy skin: axon reflexes due to low-level activity of nociceptive afferents.
        J Physiol. 1996; 497: 837-848
        • Ohkubo M
        • Hamaoka T
        • Niwayama M
        • Murase N
        • Osada T
        • Kime R
        • et al.
        Local increase in trapezius muscle oxygenation during and after acupuncture.
        Dyn Med. 2009; 8: 2
        • Crenshaw AG
        • Djupsjobacka M
        • Svedmark A
        Oxygenation, EMG and position sense during computer mouse work. Impact of active versus passive pauses.
        Eur J Appl Physiol. 2006; 97: 59-67
        • Andersen LL
        • Blangsted AK
        • Nielsen PK
        • Hansen L
        • Vedsted P
        • Sjogaard G
        • et al.
        Effect of cycling on oxygenation of relaxed neck/shoulder muscles in women with and without chronic pain.
        Eur J Appl Physiol. 2010; 110: 389-394
        • Sogaard K
        • Blangsted AK
        • Nielsen PK
        • Hansen L
        • Andersen LL
        • Vedsted P
        • et al.
        Changed activation, oxygenation, and pain response of chronically painful muscles to repetitive work after training interventions: a randomized controlled trial.
        Eur J Appl Physiol. 2012; 112: 173-181
        • Simons DG
        • Travell J
        • Simons LE
        Myofascial pain and dysfunction: the trigger point manual.
        2nd ed. Williams and Wilkins, Baltimore, MD1999