Virtual Reality and Post-dry Needling Soreness
Virtual Reality and Post-dry Needling Soreness
Application of trigger point dry needling can induce post-dry needling soreness. This is not
 a negative experience, but sometimes some patients want to reduce it as much as possible.
 Different therapeutic strategies targeting to decrease post-dry needling soreness need to be
 investigated. Previous studies have investigated spray and stretch, ischemic compression or
 low-load eccentric exercise as post-needling intervention procedures. There is increasing
 evidence supporting the role of descending pain inhibition mechanisms for paon control. The
 application of virtual reality as a distraction technique could active brain mechanisms
 during dry needling. Therefore, the objective of this study will be to investigate the
 effects of playing virtual reality during the application of dry needling on post-needling
 soreness over trigger points in the extensor carpi radialis brevis muscle. A secondary aim
 will be to determine the prognostic role of baseline scores of pressure pain sensitivity,
 related-disability, anxiety and catastrophizing levels.
Inclusion Criteria for pain-free participants:

 -  no history of upper quadrant pain symptoms the year preceding the study

 -  no history of upper quadrant surgery

 -  presence of a latent trigger point in the extensor carpi radialis brevis muscle

 Inclusion criteria for patients with elbow pain:

 -  pain over the lateral side of the elbow;

 -  pain on palpation over the lateral epicondyle or the associated common wrist extensor
 tendon;

 -  elbow pain with either resisted static contraction or stretching of the wrist extensor
 muscles.

 -  presence of an active trigger point in the extensor carpi radialis brevis muscle

 Exclusion Criteria:

 -  bilateral symptoms;

 -  older than 50 years of age;

 -  previous surgery or steroid injections;

 -  other diagnoses of upper extremity (shoulder pathology, cervical radiculopathy,
 cervical whiplash);

 -  history of cervical or upper extremity trauma;

 -  history of musculoskeletal medical conditions (rheumatoid arthritis, fibromyalgia);