Treating Spasticity in Multiple Sclerosis with Dry Needling: A Case Study

Research Objectives: Multiple sclerosis (MS) is a complex neurological condition with spasticity reported as one of the common symptoms. Spasticity also causes pain and difficulty with mobility and balance in a person with multiple sclerosis (pwMS). Dry needling (DN), defined as the insertion of thin needles into specific trigger points without injecting any substances, is a promising therapeutic technique used to manage spasticity and its consequences.

Design: A case study (NCT06394310)

Setting: Research Laboratory

Participants: A person with MS and lower leg spasticity (42y, Male, and the Patient Determined Disease Steps of 4).

Interventions: Three sessions of the DN were employed using the standard technique of spasticity.

Main Outcome Measures: The Modified Ashworth Scale, MSSS-88, and Visual Analogue Scale (VAS) were used to measure the level of spasticity before and after DN sessions. Pressure Pain Threshold (PPT) was employed to measure pain. The Timed Up and Go (TUG) test, the Timed 25-foot Walk (T25FW) test, and the MS-Walking Scale 12 (MSWS-12) were used to assess mobility. Additionally, the accelerometers were employed to evaluate balance in four conditions (combination of eyes-open or close (EO/EC) with foam or firm surface (FoM/FiM)) based on the sway area (°²). We also assessed the safety of DN, including all potential side effects.

Results: While the MAS score of both right (2 to 1) and left lower leg (2 to 1+) and spasticity VAS (8 to 6) decreased, MSSS-88 (206 to 208) did not change after DN sessions. The VAS was reported as 0 in either baseline or post-DN assessment. The PPT score increased in both medial (18.4 to 25.8 in left leg, 17.5 to 32 in right leg) and lateral gastrocnemius (18.1 to 19.3 in right leg, 17.5 to 29.3 in left leg). The time of TUG (14.81s to 13.22s) and T25FW (9.72s to 7.5s) decreased, and there were no changes with MSWS-12 (58 to 59) after DN sessions. The postural sway area decreased in three out of four conditions in the standing test (EOFiS 9.53 to 11.3, EOFoS 26.5 to 17.8, ECFiS 14.6 to 8.19, ECFoS 177 to 34.1). Participant satisfaction with DN sessions was 7 out of 10, the average pain he tolerated during the sessions was 8 out of 10, and there were no side effects of DN during the DN sessions.

Conclusions: DN showed promising results in managing spasticity and its consequences in a pwMS.

Author(s) Disclosures: This work was supported by the National Multiple Sclerosis Society (MB-1807-31633; RG-1701-26862) and MS Run the US.