Comparing Dry Needle Therapy and Extracorporeal Shockwave Therapy for Tendinopathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Zonglin Li, Yubin Chen, Lili Chen and 1 others
PMID 40678292WHAT IT FOUND
Needling alone and shockwave therapy alone gave similar pain relief in tendinopathy.
Adding needling to shockwave therapy was associated with less pain than shockwave alone at later follow-up, but evidence covers 9 trials and 528 patients.
Key findings
01Shockwave therapy and needling alone produced similar pain scores both soon after treatment and at later follow-up.
02Adding needling to shockwave therapy was associated with lower pain scores than shockwave alone at later follow-up in 3 trials with 161 patients.
03Pressure pain threshold scores did not differ between shockwave therapy and needling at final follow-up.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The review pooled only 9 trials and 528 patients across 5 different tendinopathy locations, so the combined estimate is based on a small and mixed set. The main outcomes were pain measures, and no physical function outcomes were included. The comparison was limited to shockwave therapy, needling therapy, and their combination; other physical therapies were not compared. Blinding was difficult, and 6 trials had likely performance bias; 3 trials did not specify assessor blinding. The combination versus shockwave-alone result came from only 3 trials and 161 patients.
Declared interests
The authors declare no conflict of interest.
The easy way to misread this
Do not read the combination result as proof that adding needling to shockwave therapy is the best treatment for every tendinopathy. It came from 3 trials and 161 patients, measured only pain at later follow-up, and needling alone versus shockwave alone showed similar pain scores.