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Trigger Point Electrical Dry Needling with Different Waveforms Plus Intra-Articular Corticosteroid for Knee Osteoarthritis: A Prospective Randomized Controlled Trial [Response to Letter]
Yulian Lin,1,2,* Wensen Jia,1,2,* Chang Liu,1,2,* Yujia Tang,1,2 Yan Yuan2,3
1Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China; 2School of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China; 3Department of Pain Treatment, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yulian Lin, Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China, Email [email protected]
View the original paper by Dr Lin and colleagues
This is in response to the Letter to the Editor
Dear editor
We greatly appreciate Yu Y and colleagues for their careful reading of and valuable comments on our randomized controlled trial. Their discussions on mechanisms and methodology provide important directions for future electrical dry needling research.
We fully agree that broader frequency alternations (e.g., 2/100 Hz) should be compared with the 2/10 Hz dense-disperse waveform to screen optimal stimulation parameters for knee osteoarthritis. We also acknowledge the modest between-group difference in the numerical rating scale at week 12, which makes us interpret our results cautiously. Additional trials comparing various frequency regimens are needed to determine the ideal parameter combination.
We endorse the correspondents’ myofascial chain therapeutic perspective. Guided by holistic mechanical principles, we treated core muscle groups synchronously in our intervention. Meanwhile, we noted partial overlap between the trigger points that we selected and classic acupoints. As suggested, quantitative sensory testing on remote sites in follow-up studies will help to differentiate local peripheral analgesia from supraspinal central regulatory effects.
We will carry out relevant mechanistic and parameter optimization trials based on these constructive suggestions.
Disclosure
The authors report no conflicts of interest in this communication.
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