Therapeutic effects of dry needling for patellofemoral pain syndrome: a systematic review and meta-analysis

Abstract

Background and purpose

Dry needling has been increasingly used as an adjunctive therapy for patellofemoral pain syndrome in clinical practice. This study aimed to summarize the available evidence about the effects of dry needling in managing patellofemoral pain syndrome.

Methods

Seven English-language databases and three Chinese-language databases were searched. Two researchers independently screened the literature, extracted data, and assessed the risk of bias using the PEDro scale and the Cochrane Risk of Bias Assessment Tool. The quality of evidence was evaluated using the GRADE approach.

Results

A total of 12 studies were included, involving 624 participants. Dry needling significantly improved knee pain (MD = −0.86, 95%CI -1.17 to −0.55) and physical function (MD = 5.33, 95%CI 3.88 to 6.78) compared to comparative groups. When combined with exercise therapy, dry needling resulted in large reduction in knee pain(MD = −2.02, 95%CI -2.36 to −1.67) and small improvement in physical function (MD = 9.56, 95%CI 7.84 to 11.27) compared to exercise therapy alone. However, negligible or no additional benefits were observed when dry needling was added to extracorporeal shock wave therapy or multimodal interventions. Furthermore, dry needling showed no significant advantage over other trigger point therapies in terms of pain reduction and functional improvement.

Conclusion

Dry needling is effective in reducing pain and improving function for patients with patellofemoral pain syndrome, particularly when combined with exercise therapy. However, more high-quality studies are required to draw a definitive conclusion.

Clinical trial registration number

CRD42023490627 on PROSPERO.