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Is Dry Needling of the Supinator a Safe Procedure? A Potential Treatment for Lateral Epicondylalgia or Radial Tunnel Syndrome. A Cadaveric Study

Author

Listed:
  • César Fernández-de-las-Peñas

    (Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), 28922 Alcorcón, Spain
    Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain)

  • Carlos López-de-Celis

    (Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC-Barcelona), C/Josep Trueta s/n, Sant Cugat del Vallès, 08017 Barcelona, Spain
    ACTIUM Functional Anatomy Group, 08195 Barcelona, Spain
    Equal contribution.)

  • Jacobo Rodríguez-Sanz

    (Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC-Barcelona), C/Josep Trueta s/n, Sant Cugat del Vallès, 08017 Barcelona, Spain
    ACTIUM Functional Anatomy Group, 08195 Barcelona, Spain)

  • César Hidalgo-García

    (Unidad de Investigación en Fisioterapia, Universidad de Zaragoza, 50001 Zaragoza, Spain)

  • Joseph M. Donnelly

    (Department of Physical Therapy, Miami Campus, University of Saint Augustine for Health Sciences, Coral Gables, FL 33134, USA)

  • Simón A Cedeño-Bermúdez

    (Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC-Barcelona), C/Josep Trueta s/n, Sant Cugat del Vallès, 08017 Barcelona, Spain
    ACTIUM Functional Anatomy Group, 08195 Barcelona, Spain)

  • Albert Pérez-Bellmunt

    (Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC-Barcelona), C/Josep Trueta s/n, Sant Cugat del Vallès, 08017 Barcelona, Spain
    ACTIUM Functional Anatomy Group, 08195 Barcelona, Spain
    Equal contribution.)

Abstract

The supinator muscle is involved in two pain conditions of the forearm and wrist: lateral epicondylalgia and radial tunnel syndrome. Its close anatomical relationship with the radial nerve at the arcade of Frohse encourages research on dry needling approaches. Our aim was to determine if a solid filiform needle safely penetrates the supinator muscle during the clinical application of dry needling. Needle insertion of the supinator muscle was conducted in ten cryopreserved forearm specimens with a 30 × 0.32 mm filiform needle. With the forearm pronated, the needle was inserted perpendicular into the skin at the dorsal aspect of the forearm at a point located 4cm distal to the lateral epicondyle. The needle was advanced to a depth judged to be in the supinator muscle. Safety was assessed by measuring the distance from the needle to the surrounding neurovascular bundles of the radial nerve. Accurate needle penetration of the supinator muscle was observed in 100% of the forearms (needle penetration:16.4 ± 2.7 mm 95% CI 14.5 mm to 18.3 mm). No neurovascular bundle of the radial nerve was pierced in any of the specimen’s forearms. The distances from the tip of the needle were 7.8 ± 2.9 mm (95% CI 5.7 mm to 9.8 mm) to the deep branch of the radial nerve and 8.6 ± 4.3 mm (95% CI 5.5 mm to 11.7 mm) to the superficial branch of the radial nerve. The results from this cadaveric study support the assumption that needling of the supinator muscle can be accurately and safely conducted by an experienced clinician.

Suggested Citation

  • César Fernández-de-las-Peñas & Carlos López-de-Celis & Jacobo Rodríguez-Sanz & César Hidalgo-García & Joseph M. Donnelly & Simón A Cedeño-Bermúdez & Albert Pérez-Bellmunt, 2021. "Is Dry Needling of the Supinator a Safe Procedure? A Potential Treatment for Lateral Epicondylalgia or Radial Tunnel Syndrome. A Cadaveric Study," IJERPH, MDPI, vol. 18(17), pages 1-7, August.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:17:p:9162-:d:625878
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    Citations

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    Cited by:

    1. Pedro Belón-Pérez & Laura Calderón-Díez & José Luis Sánchez-Sánchez & Miguel Robles-García & Gustavo Plaza-Manzano & César Fernández-de-las-Peñas, 2022. "Cadaveric and Ultrasound Validation of Percutaneous Electrolysis Approaches at the Arcade of Frohse: A Potential Treatment for Radial Tunnel Syndrome," IJERPH, MDPI, vol. 19(4), pages 1-7, February.

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