574 - Vertigo and Neck Pain Management through Ultrasound-Guided Dry Needling: A Randomized Controlled Trial

Objectives: Vertigo and neck pain are debilitating symptoms often associated with musculoskeletal issues following skull trauma. This study aimed to investigate the effectiveness of ultrasound-guided dry needling (DN) as a therapeutic intervention for combat patients suffering from these symptoms.

Design: A randomized controlled trial (RCT) was conducted with a study population presenting both neck pain and vertigo. Ten patients were assigned to the treatment group, receiving standard DN targeting deep muscles and the pterygoid region. Ten patients comprised the control group, undergoing standard DN combined with a sham procedure involving superficial deltoid muscles. The DN procedure involved comprehensive assessments, including general medical examination, MRI, precise physical tests, and extensive functional multiparameter neuromuscular ultrasound (US). Detected myofascial trigger points (MTrPs) were treated under US guidance. Visual Analog Scale (VAS) scores, physical examinations, and functional ultrasound assessments were used as outcome measures. Patients' progress was evaluated after one month.

Results: Active and latent MTrPs were identified in various muscles, including rectus and obliquus capitis, shoulder rotators, and medial and lateral pterygoid muscles. Patients exhibited individual-specific MTrP patterns. DN successfully treated shoulder dysfunction associated with active trigger points in shoulder rotator muscles. Immediate and clinically significant reductions in tension-type headache and neck pain (80% reduction by VAS) were observed after one session. In the treatment group, vertigo and neck craniofacial pain ameliorated immediately, with prolonged relief for those receiving pterygoid muscle needling. The control group showed moderate head pain improvement without changes in vertigo.

Conclusions: Ultrasound-guided DN may effectively manage vertigo and neck pain associated with musculoskeletal issues. Further research with larger samples and extended follow-up is needed to confirm long-term efficacy and safety. A multidisciplinary approach and experienced practitioners are essential for patient well-being.