Inclusion criteria:
Presence of shoulder pain for at least three months
Existence of trigger points with three characteristics: 1. Existence of a palpable knot in the skeletal muscle band.2. Existence of excessive points Irritable in taut band 3. Patients who report local or referred pain after mechanical stimulation of trigger points. (with the difference that latent trigger points become painful only after mechanical stimulation and active points even without stimulation. It is a mechanism that causes myofascial pain )
The presence of at least one trigger point in two of the four rotator cuff muscles
Exclusion criteria:
History of shoulder and neck surgery
Instability of the glenohumeral joint and serious diseases related to the joint of cervical vertebrae, ang glenohumeral joint
History of corticosteroid injections or local anesthetics in the past year
Symptoms indicating systemic disorders
History of any physiotherapy in the last 3 months
History of diagnosis or medical reports about the presence of myopathy and neuropathy
Cognitive problems
Patients with any limitations in dry needling treatment (fear of needles, patient dissatisfaction, lymphoedema, Acute and emergency conditions, patients with coagulation problems, immune system disorders, vascular problems, diabetes, epilepsy, allergy to metals, patients with mental disorders, use of anticoagulants)
Use of anti-platelet, anti-coagulant, anti-pain and anti-inflammatory drugs in the last three months
Cardiovascular, rheumatoid, and neurological problems
History of rotator cuff tears