1Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
2Department of Korean Medicine Rehabilitation, School of Korean Medicine, Pusan National University, Yangsan, Republic of Korea
3Department of Rehabilitation Medicine of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
4Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
©2024 Jaseng Medical Foundation
This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).
Author Contributions
Conceptualization: SHL, YJL, and IHH. Methodology: SHL, YJL, and IHH. Formal investigation: SHL, YJL, and IHH. Writing original draft: SHL. Writing-review and editing: YJL, JYK, IH, JHC, BKS, YCP, JHK, and IHH.
Conflicts of Interest
SHL is a managing editor, and YJL and IHH are the editors of Perspectives on Integrative Medicine, but this had no influence in the decision to publish this article. No other potential conflict of interest relevant to this article was reported.
Funding
This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (grant no.: RS-2023-KH139336).
Ethical Statement
This research did not involve any human or animal experiments.
Author (y) | Study design | Country | Disease (intervention/control) | Type of intervention | Control | Outcomes | Main results | Adverse events |
---|---|---|---|---|---|---|---|---|
Ultrasound-guided acupuncture (RCT: 4, CT: 1, Case series: 1) | ||||||||
Wu (2023) [10] | RCT | China | Lower limb muscle spasm after stroke (30/30) | Ultrasound-guided acupuncture + conventional treatment (medication and RT) | Conventional treatment (medication and RT) |
1) 10 m walking speed 2) FMA 3) IEMG 4) RMS |
Diff between 2 groups after tx 10-m walking speed, FMA, IEMG, and RMS (p < 0.05) |
Not specified |
Duan (2022) [11] | RCT | China | Lumbar disc herniation (40/40) | Ultrasound-guided elongated needling | Ultrashort wave therapy |
1) VAS 2) JOA 3) ODI 4) Effective rate |
Diff between 2 groups after 3 weeks tx VAS, JOA, and Oswestry score (p < 0.05) JOA score improvement rate: Tx 95%, Ctrl 80% Effective rate: Tx 95%, Ctrl 82.5% |
Not specified |
Liu (2022) [12] | RCT | China | Pes anserinus bursitis (25/25) | Ultrasound-guided acupuncture + conventional treatment (RT) | Conventional treatment (Injection + RT) |
1) VAS 2) Lysholm 3) QOL 4) Effective rate |
Diff between 2 groups after tx VAS, Lysholm, and QOL (p < 0.05) Effective rate: Tx 96%, Ctrl 68% |
Not specified |
Pan (2021) [3] | RCT | China | Non-specific low back pain (30/30) | Ultrasound-guided acupuncture | Acupuncture |
1) VAS 2) JOA 3) Young’s modulus value 4) Effective rate |
Diff between 2 groups after tx VAS and JOA (p < 0.05) Effective rate: 1 month Tx 93.33%, Ctrl 70% |
Not specified |
Zhong (2020) [13] | CT | China | Lateral epicondylitis (28/28) | Ultrasound-guided floating acupuncture | Standard floating acupuncture |
1) NPRS 2) Mayo elbow joint functional score |
Diff between after tx NRS and Mayo elbow joint functional score (p < 0.05) |
Not specified |
Parthasarathy (2022) [14] | Case series | India | Wrist drop (1); Tennis elbow (1) | Ultrasonography-guided needling; ultrasonography |
1) Motor power 2) Pain scale |
Motor power regained to 3/5–4/5 Pain reduction (2–3/10) and improvement in joint movement |
Tx 1: (N=0) Tx 2: Not specified |
|
Ultrasound-guided warming acupuncture (RCT: 3) | ||||||||
Zhou (2023) [15] | RCT | China | Low back pain (30/30) | Ultrasound-guided hot acupuncture | Acupuncture |
1) VAS 2) Effective rate |
Diff between 2 groups after tx VAS: 1 day, 1 week, and 6 months (p < 0.05) Lumbar spine activity score: 1 week and 6 months (p < 0.05) Effective rate: Tx 93.33%, Ctrl 76.67%, (p < 0.05) |
Tx: (n = 0) Ctrl: (n = 1, hematoma) |
Wang (2022) [16] | RCT | China | Low back pain (60/60) | Ultrasound-guided internal heating acupuncture + moxibustion | Conventional treatment (medication) |
1) VAS 2) PSQI 3) ODI 4) BALP 5) BGP 6) Effective rate |
Diff between 2 groups after tx VAS, PSQI, and ODI: 1 week, 3 months, and 6 months (p < 0.05) serum BALP and BGP: 3 and 6 months (p < 0.05) Effective rate: Tx 95%, Ctrl 76.67% |
Tx: (n = 0) Ctrl: (n = 0) |
Zhang (2019) [17] | RCT | China | Cervical spondylosis (60/60) | Ultrasound-guided warming acupuncture and moxibustion | Warming acupuncture and moxibustion |
1) VAS 2) PRI 3) PPI 4) NOOS-C 5) Effective rate |
Diff between 2 groups after tx VAS, PRI, and PPI (p < 0.05) Effective rate Tx 90.0%, Ctrl 78.3% (p < 0.05) |
Not specified |
Ultrasound-guided DN (RCT: 8, case series: 1, case report 1) | ||||||||
Sharif (2023) [18] | RCT | Pakistan | Jumper’s knee (96) | Ultrasound-guided DN + conventional treatment (RT) | Conventional treatment (RT) |
1) VAS 2) KOOS 3) VISA-P questionnaire 4) Lysholm knee scoring scale |
Diff between 2 groups after 4 weeks tx VAS, VISA-P, KOOS, and Lysholm (p ≤ 0.05) |
Not specified |
Pang (2022) [19] | RCT | Australia | Knee osteoarthritis (30/30/30) | Ultrasound-guided DN + conventional treatment (RT) |
1) Placebo US-guided DN Conventional treatment (RT) 2) Conventional treatment (RT) |
1) VAS 2) KOOS |
Diff between 2 groups after 8 weeks tx VAS and KOOS-pain (p < 0.05) |
Tx: (n = 0) Ctrl: (n = 0) |
Sharif (2022) [20] | RCT | Pakistan | Jumper’s knee (47/47) | Ultrasound-guided DN + conventional treatment (RT) | Conventional treatment (RT) |
1) VAS 2) Lysholm knee scoring 3) VISA-P 4) KOOS |
Diff between 2 groups after 2, 4 weeks tx VAS, Lysholm, VISA-P, and KOOS (p < 0.05) |
Not specified |
Huang (2022) [21] | RCT | China | Myofascial pain syndrome (28/28) | Ultrasound-guided DN | Conventional treatment (Medication) |
1) VAS 2) MPQ |
Diff between 2 groups after tx VAS and MPQ (p < 0.05) Effective rate: 1 month Tx 92.9%, Ctrl 38.5% |
Tx: (n = 6) Ctrl: (n = 14) Dizziness, nausea, and vomiting. No serious adverse reactions |
Ceballos-Lait (2021) [22] | RCT | Spain | Myofascial pain syndrome (15/15) | Ultrasound-guided DN | No intervention |
1) NPRS 2) Shoulder ROM 3) Muscle strength 4) Extensibility |
Diff between 2 groups after tx NPRS (p < 0.001; E.S: 1.3) Internal rotation ROM (p < 0.001; E.S: 3.0) Extensibility (p < 0.001; E.S: 2.9) |
Not specified |
Xie (2019) [23] | RCT | China | Myofascial trigger points in plantar fasciitis (24/24) | Ultrasound-guided DN+stretching training | Sole non-weight-bearing plantar fascia stretching training |
1) NPRS 2) AOFAS 3) SF-36(PCS, MCS) |
Diff between 2 groups after tx NPRS (p < 0.01) AOFAS and SF-36 PCS (p < 0.05) SF-36 MCS (p > 0.05) |
Not specified |
Tabatabaiee (2019) [24] | RCT | Iran | Piriformis syndrome (32) | Ultrasound-guided DN + advice | Wait list (advice only) |
1) VAS 2) ODI 3) PPT 4) HIR/HER 5) Hip ROM |
Diff between 2 groups after tx VAS 1 week: (p = 0.007) ODI 72 h: -5.9 [−0.3 to -11.5] (p = 0.02) PPT 72 h: 2.9 [5.1–0.6] (p < 0.01) HIR 72 h: 3.4 [5.2–1.7] (p < 0.01) HER 72 h: 1.2 [2.8–0.4] (p = 0.15) |
Tx: (n = 2) Ctrl: (n = 0) Severe pain in 1 and bleeding in the other. |
Bubnov (2013) [25] | RCT | USA | Myofascial pain syndrome (91/42) | Ultrasound-guided TrP-DN | TrP-DN therapy | 1) VAS |
VAS 24 h: significant reduction (p < 0.001); Tx 84%, Ctrl 63.5% |
Not specified |
Fusco (2018) [26] | Case series | Italy | Piriformis syndrome (3) | Convex probe and a 0.30 × 60 mm needle, diclofenac 50 mg, tapentadol 100 mg and paracetamol 500 mg, ibuprofen 600 mg | 1) NPRS | Symptoms resolved | Not specified | |
Roy (2013) [27] | Case report | USA | Supraspinatus tendinopathy | Ultrasound-guided DN |
1) VAS 2) ROM |
Symptoms resolved | Not specified | |
Ultrasound-guided EA (RCT: 2, CT: 1, Case series: 1 Case report: 2) | ||||||||
Jin (2022) [28] | RCT | China | Suprahyoid muscle group for pharyngeal dysphagia after stroke (40/40/40) | Ultrasound-guided EA |
1) EA at Lianquan (CV 23), Wangu (GB 12) and Fengchi (GB 20) 2) EA at suprahyoid muscle group |
1) PAS 2) VFSS |
Diff between 2 groups after tx PAS and VFSS (p < 0.05) |
Tx: (n = 0) Ctrl 1: (n = 8) Ctrl 2: (n = 19) hematoma |
Liu (2018) [29] | RCT | China | Intractable hiccup | Ultrasound-guided acupuncture | Acupuncture | 1) Effective rate |
Diff between 2 groups after tx Effective rate: Tx 86.7%, Ctrl 66.7% (p < 0.05) |
Tx: (n = 0) Ctrl: (n = 0) |
Valera-Garrido (2014) [30] | CT | Spain | Chronic lateral epicondylitis (36) | Ultrasound-guided PNE | Conventional treatment (RT) |
1) VAS 2) DASH |
Diff between baseline and discharge VAS, pain-free pressure, evoked pain by tests, and DASH (p < 0.001) Recurrence rates were null after discharge and at follow-up at 6, 26, and 52 weeks |
Not specified |
Zheng (2004) [31] | Case series | China | Superficial angioma (861) | Ultrasound-guided EA | Best response according to the WHO | CR (87.2%), PR (7.4%) | Not specified | |
Afonso (2023) [32] | Case report | Portugal | Thoracic myofascial pain syndrome (1) | Ultrasound-guided EA |
1) NPS 2) ROM 3) Sleep and mood |
NPS reduction (7–3), improved range of motion, and better sleep, but the mood did not improve. | Not specified | |
Song (2022) [33] | Case report | China | Spinal cord injury (1) | Ultrasound-guided EA |
1) ASIA 2) FIM |
ASIA: Significantly increased the motor scores (58–64), the sensory score (160–186) FIM: Significantly increased (81–114) after sacral EA stimulation |
Not specified |
AOFAS = Ankle Society hindfoot score; BALP = bone alkaline phosphatase; BGP = osteocalcin bone gamma-Gla protein; CT = clinical trials; DN = dry needling; EA = electroacupuncture; FMA = Fugl–Meyer assessment score; HIR = hip internal rotational range of motion; HER = hip external rotational range of motion; iEMG = integrated electromyography; RMS = root mean square; JOA = Japanese orthopaedic association; KOOS = knee injury and osteoarthritis outcome score; MPQ = McGill pain questionnaire; NOOS-C = neck outcome score (Chinese version); NPRS = numeric pain-rating scale; NPS = numeric pain scale; ODI = Oswestry Disability Index; PAS = penetration-aspiration scale; PNE = percutaneous needle electrolysis; PPI = present pain intensity; PPT = pain pressure threshold; PPRI = pain rating index; PSQI = Pittsburgh sleep quality index; QOL = quality of life scale; RCTs = randomized controlled trials; RT = rehabilitation treatment; TrP-DN = trigger point dry needling; VAS = visual analogue scale; VISA-P questionnaire = Victorian institute of sports assessment-patellar tendinopathy questionnaire; VFSS = video fluoroscopic swallowing study.
Author (y) | Study design | Country | Disease (intervention/control) | Type of intervention | Control | Outcomes | Main results | Adverse events |
---|---|---|---|---|---|---|---|---|
Ultrasound-guided acupuncture (RCT: 4, CT: 1, Case series: 1) | ||||||||
Wu (2023) [ |
RCT | China | Lower limb muscle spasm after stroke (30/30) | Ultrasound-guided acupuncture + conventional treatment (medication and RT) | Conventional treatment (medication and RT) | 1) 10 m walking speed 2) FMA 3) IEMG 4) RMS |
Diff between 2 groups after tx 10-m walking speed, FMA, IEMG, and RMS (p < 0.05) |
Not specified |
Duan (2022) [ |
RCT | China | Lumbar disc herniation (40/40) | Ultrasound-guided elongated needling | Ultrashort wave therapy | 1) VAS 2) JOA 3) ODI 4) Effective rate |
Diff between 2 groups after 3 weeks tx VAS, JOA, and Oswestry score (p < 0.05) JOA score improvement rate: Tx 95%, Ctrl 80% Effective rate: Tx 95%, Ctrl 82.5% |
Not specified |
Liu (2022) [ |
RCT | China | Pes anserinus bursitis (25/25) | Ultrasound-guided acupuncture + conventional treatment (RT) | Conventional treatment (Injection + RT) | 1) VAS 2) Lysholm 3) QOL 4) Effective rate |
Diff between 2 groups after tx VAS, Lysholm, and QOL (p < 0.05) Effective rate: Tx 96%, Ctrl 68% |
Not specified |
Pan (2021) [ |
RCT | China | Non-specific low back pain (30/30) | Ultrasound-guided acupuncture | Acupuncture | 1) VAS 2) JOA 3) Young’s modulus value 4) Effective rate |
Diff between 2 groups after tx VAS and JOA (p < 0.05) Effective rate: 1 month Tx 93.33%, Ctrl 70% |
Not specified |
Zhong (2020) [ |
CT | China | Lateral epicondylitis (28/28) | Ultrasound-guided floating acupuncture | Standard floating acupuncture | 1) NPRS 2) Mayo elbow joint functional score |
Diff between after tx NRS and Mayo elbow joint functional score (p < 0.05) |
Not specified |
Parthasarathy (2022) [ |
Case series | India | Wrist drop (1); Tennis elbow (1) | Ultrasonography-guided needling; ultrasonography | 1) Motor power 2) Pain scale |
Motor power regained to 3/5–4/5 Pain reduction (2–3/10) and improvement in joint movement |
Tx 1: (N=0) Tx 2: Not specified | |
Ultrasound-guided warming acupuncture (RCT: 3) | ||||||||
Zhou (2023) [ |
RCT | China | Low back pain (30/30) | Ultrasound-guided hot acupuncture | Acupuncture | 1) VAS 2) Effective rate |
Diff between 2 groups after tx VAS: 1 day, 1 week, and 6 months (p < 0.05) Lumbar spine activity score: 1 week and 6 months (p < 0.05) Effective rate: Tx 93.33%, Ctrl 76.67%, (p < 0.05) |
Tx: (n = 0) Ctrl: (n = 1, hematoma) |
Wang (2022) [ |
RCT | China | Low back pain (60/60) | Ultrasound-guided internal heating acupuncture + moxibustion | Conventional treatment (medication) | 1) VAS 2) PSQI 3) ODI 4) BALP 5) BGP 6) Effective rate |
Diff between 2 groups after tx VAS, PSQI, and ODI: 1 week, 3 months, and 6 months (p < 0.05) serum BALP and BGP: 3 and 6 months (p < 0.05) Effective rate: Tx 95%, Ctrl 76.67% |
Tx: (n = 0) Ctrl: (n = 0) |
Zhang (2019) [ |
RCT | China | Cervical spondylosis (60/60) | Ultrasound-guided warming acupuncture and moxibustion | Warming acupuncture and moxibustion | 1) VAS 2) PRI 3) PPI 4) NOOS-C 5) Effective rate |
Diff between 2 groups after tx VAS, PRI, and PPI (p < 0.05) Effective rate Tx 90.0%, Ctrl 78.3% (p < 0.05) |
Not specified |
Ultrasound-guided DN (RCT: 8, case series: 1, case report 1) | ||||||||
Sharif (2023) [ |
RCT | Pakistan | Jumper’s knee (96) | Ultrasound-guided DN + conventional treatment (RT) | Conventional treatment (RT) | 1) VAS 2) KOOS 3) VISA-P questionnaire 4) Lysholm knee scoring scale |
Diff between 2 groups after 4 weeks tx VAS, VISA-P, KOOS, and Lysholm (p ≤ 0.05) |
Not specified |
Pang (2022) [ |
RCT | Australia | Knee osteoarthritis (30/30/30) | Ultrasound-guided DN + conventional treatment (RT) | 1) Placebo US-guided DN Conventional treatment (RT) 2) Conventional treatment (RT) |
1) VAS 2) KOOS |
Diff between 2 groups after 8 weeks tx VAS and KOOS-pain (p < 0.05) |
Tx: (n = 0) Ctrl: (n = 0) |
Sharif (2022) [ |
RCT | Pakistan | Jumper’s knee (47/47) | Ultrasound-guided DN + conventional treatment (RT) | Conventional treatment (RT) | 1) VAS 2) Lysholm knee scoring 3) VISA-P 4) KOOS |
Diff between 2 groups after 2, 4 weeks tx VAS, Lysholm, VISA-P, and KOOS (p < 0.05) |
Not specified |
Huang (2022) [ |
RCT | China | Myofascial pain syndrome (28/28) | Ultrasound-guided DN | Conventional treatment (Medication) | 1) VAS 2) MPQ |
Diff between 2 groups after tx VAS and MPQ (p < 0.05) Effective rate: 1 month Tx 92.9%, Ctrl 38.5% |
Tx: (n = 6) Ctrl: (n = 14) Dizziness, nausea, and vomiting. No serious adverse reactions |
Ceballos-Lait (2021) [ |
RCT | Spain | Myofascial pain syndrome (15/15) | Ultrasound-guided DN | No intervention | 1) NPRS 2) Shoulder ROM 3) Muscle strength 4) Extensibility |
Diff between 2 groups after tx NPRS (p < 0.001; E.S: 1.3) Internal rotation ROM (p < 0.001; E.S: 3.0) Extensibility (p < 0.001; E.S: 2.9) |
Not specified |
Xie (2019) [ |
RCT | China | Myofascial trigger points in plantar fasciitis (24/24) | Ultrasound-guided DN+stretching training | Sole non-weight-bearing plantar fascia stretching training | 1) NPRS 2) AOFAS 3) SF-36(PCS, MCS) |
Diff between 2 groups after tx NPRS (p < 0.01) AOFAS and SF-36 PCS (p < 0.05) SF-36 MCS (p > 0.05) |
Not specified |
Tabatabaiee (2019) [ |
RCT | Iran | Piriformis syndrome (32) | Ultrasound-guided DN + advice | Wait list (advice only) | 1) VAS 2) ODI 3) PPT 4) HIR/HER 5) Hip ROM |
Diff between 2 groups after tx VAS 1 week: (p = 0.007) ODI 72 h: -5.9 [−0.3 to -11.5] (p = 0.02) PPT 72 h: 2.9 [5.1–0.6] (p < 0.01) HIR 72 h: 3.4 [5.2–1.7] (p < 0.01) HER 72 h: 1.2 [2.8–0.4] (p = 0.15) |
Tx: (n = 2) Ctrl: (n = 0) Severe pain in 1 and bleeding in the other. |
Bubnov (2013) [ |
RCT | USA | Myofascial pain syndrome (91/42) | Ultrasound-guided TrP-DN | TrP-DN therapy | 1) VAS | VAS 24 h: significant reduction (p < 0.001); Tx 84%, Ctrl 63.5% |
Not specified |
Fusco (2018) [ |
Case series | Italy | Piriformis syndrome (3) | Convex probe and a 0.30 × 60 mm needle, diclofenac 50 mg, tapentadol 100 mg and paracetamol 500 mg, ibuprofen 600 mg | 1) NPRS | Symptoms resolved | Not specified | |
Roy (2013) [ |
Case report | USA | Supraspinatus tendinopathy | Ultrasound-guided DN | 1) VAS 2) ROM |
Symptoms resolved | Not specified | |
Ultrasound-guided EA (RCT: 2, CT: 1, Case series: 1 Case report: 2) | ||||||||
Jin (2022) [ |
RCT | China | Suprahyoid muscle group for pharyngeal dysphagia after stroke (40/40/40) | Ultrasound-guided EA | 1) EA at Lianquan (CV 23), Wangu (GB 12) and Fengchi (GB 20) 2) EA at suprahyoid muscle group |
1) PAS 2) VFSS |
Diff between 2 groups after tx PAS and VFSS (p < 0.05) |
Tx: (n = 0) Ctrl 1: (n = 8) Ctrl 2: (n = 19) hematoma |
Liu (2018) [ |
RCT | China | Intractable hiccup | Ultrasound-guided acupuncture | Acupuncture | 1) Effective rate | Diff between 2 groups after tx Effective rate: Tx 86.7%, Ctrl 66.7% (p < 0.05) |
Tx: (n = 0) Ctrl: (n = 0) |
Valera-Garrido (2014) [ |
CT | Spain | Chronic lateral epicondylitis (36) | Ultrasound-guided PNE | Conventional treatment (RT) | 1) VAS 2) DASH |
Diff between baseline and discharge VAS, pain-free pressure, evoked pain by tests, and DASH (p < 0.001) Recurrence rates were null after discharge and at follow-up at 6, 26, and 52 weeks |
Not specified |
Zheng (2004) [ |
Case series | China | Superficial angioma (861) | Ultrasound-guided EA | Best response according to the WHO | CR (87.2%), PR (7.4%) | Not specified | |
Afonso (2023) [ |
Case report | Portugal | Thoracic myofascial pain syndrome (1) | Ultrasound-guided EA | 1) NPS 2) ROM 3) Sleep and mood |
NPS reduction (7–3), improved range of motion, and better sleep, but the mood did not improve. | Not specified | |
Song (2022) [ |
Case report | China | Spinal cord injury (1) | Ultrasound-guided EA | 1) ASIA 2) FIM |
ASIA: Significantly increased the motor scores (58–64), the sensory score (160–186) FIM: Significantly increased (81–114) after sacral EA stimulation |
Not specified |
AOFAS = Ankle Society hindfoot score; BALP = bone alkaline phosphatase; BGP = osteocalcin bone gamma-Gla protein; CT = clinical trials; DN = dry needling; EA = electroacupuncture; FMA = Fugl–Meyer assessment score; HIR = hip internal rotational range of motion; HER = hip external rotational range of motion; iEMG = integrated electromyography; RMS = root mean square; JOA = Japanese orthopaedic association; KOOS = knee injury and osteoarthritis outcome score; MPQ = McGill pain questionnaire; NOOS-C = neck outcome score (Chinese version); NPRS = numeric pain-rating scale; NPS = numeric pain scale; ODI = Oswestry Disability Index; PAS = penetration-aspiration scale; PNE = percutaneous needle electrolysis; PPI = present pain intensity; PPT = pain pressure threshold; PPRI = pain rating index; PSQI = Pittsburgh sleep quality index; QOL = quality of life scale; RCTs = randomized controlled trials; RT = rehabilitation treatment; TrP-DN = trigger point dry needling; VAS = visual analogue scale; VISA-P questionnaire = Victorian institute of sports assessment-patellar tendinopathy questionnaire; VFSS = video fluoroscopic swallowing study.