José Luis Arias-Buría

• PT graduate, MSc, PhD
• Professor at Rey Juan Carlos University

Objective This meta-analysis evaluated the prevalence of neuropathic-like symptoms in individuals with painful tendinopathies/overuse injuries. Methods Electronic literature searches on MEDLINE, CINAHL, PubMed, SCOPUS and Web of Science databases were conducted up to January 20 th , 2025. Studies reporting the prevalence of neuropathic-like sympto...

Needling of obliquus capitis inferior (OCI) muscle could be an important intervention for individuals with upper cervical pain; however, precision is important due to its sensitive location. The aim was to assess the accuracy, safety and performance of needling OCI using palpation versus ultrasound-guidance in a cadaveric model. A cross-sectional a...

High-level sports practice can generate tissue adaptations in the athlete's musculotendinous structures. In asymmetrical sports, such as badminton, these adaptations can vary between the dominant and non-dominant side. The aim of the study was to evaluate the structural and functional characteristics of the common extensor tendon in professional ba...

Objective The aims of the current study were to investigate the presence of widespread pressure hyperalgesia, the presence of structural changes in the wrist extensor tendon and muscle, and their association in people with lateral epicondylalgia (LE). Methods Thirty-seven patients with LE (43% women; mean age = 45.5 [SD = 9.5] years) and 37 contro...

Objective: Percutaneous electrical nerve stimulation (PENS) appears to be effective for the treatment of musculoskeletal pain. The aim of this trial was to investigate the effects on disability and pain, as well as on the psychological aspects of adding PENS into an exercise program in patients with subacromial pain syndrome. Methods: A randomized,...

Background: Evidence suggests the plantar fascia and its interphase with the flexor digitorum brevis muscle can play a relevant role in plantar heel pain. Needling interventions could offer an appropriate treatment strategy to addressing this interface. Objective: We compared the accuracy and safety of ultrasound-guided versus palpation-guided proc...

Background: Evidence suggests the plantar fascia and its interphase with the flexor digitorum brevis muscle can play a relevant role in plantar heel pain. Needling interventions could offer an appropriate treatment strategy to addressing this interface. Objective: We compared the accuracy and safety of ultrasound-guided versus palpation-guided p...

For decades, needling interventions have been performed based on manual palpation and anatomic knowledge. The increasing use of real-time ultrasonography in clinical practice has improved the accuracy and safety of needling techniques. Although currently ultrasound-guided procedures are routinely used for patellar tendon pathology, e.g., during per...

Objectives: We evaluate the presence of sensitization-associated symptoms and neuropathic pain features and identify if there is an association between these symptoms and pressure pain sensitivity, pain, and related-disability in lateral elbow tendinopathy. Methods: Thirty-seven (43% women, age: 45.5 ± 9.5 years) patients with lateral elbow tend...

Some authors have proposed the potential role of the radial nerve in lateral epicondylalgia. The aims of this study were to investigate the presence of pressure pain hyperalgesia and nerve swelling (increased cross-sectional area) assessed with ultrasound imaging on the radial nerve in people with lateral epicondylalgia, and to investigate if an as...

Temporomandibular disorder (TMD) is an umbrella term including pain problems involving the cranio-cervical region. It has been suggested that patients with TMD also exhibit cervical spine disturbances. Evidence suggests the presence of morphological changes in the deep cervical muscles in individuals with headaches. The objective of this study was...

Objective: The aim of this clinical trial was to compare the outcomes of the application of ultrasound-guided percutaneous nerve stimulation (PENS) targeting the median nerve versus surgery for improving pain and function in women with CTS. Methods: In this randomized parallel-group trial (ClinicalTrials.gov, NCT04246216), 70 women with CTS were...

Introduction Knee and hip osteoarthritis are two highly prevalent musculoskeletal pain conditions. Unsuccessful rates after hip/knee replacement range from 10% to 20%. Subjects with sensitisation manifestations are vulnerable to worse clinical outcomes. Most studies have analysed outcomes up to 1 year after surgery. The aim of this 2-year longitudi...

Objective: The nociceptive pain processing of soft tissue overuse conditions is under debate as no consensus currently exists. The purpose of this meta-analysis was to compare pressure pain thresholds (PPTs) in symptomatic and distant pain-free areas in 2 groups: participants with symptomatic lower extremity overuse soft tissue conditions and cont...

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus is associated with psychological/emotional disturbances. This study aimed to assess internal consistency, reliability, and construct validity of the Hospital Anxiety and Depressive Scale (HADS), as a patient-reported outcome measure (PROM) for evaluating emotional consequences of SA...

This paper assesses the effects of percutaneous electrical nerve stimulation (PENS) on pain- and function-related outcomes by means of a scoping review of studies with single cases, case-series, quasi-experimental, and randomized or non-randomized trial designs. We consulted the PubMed, MEDLINE and EMBASE databases. Data were extracted by two revie...

Objective: To investigate the relationship between pain extent, as a clinical sign of central sensitization, and clinical, psychological, and pressure sensitivity in women with fibromyalgia syndrome (FMS). Method: In this study, 126 females with FMS completed demographic (age, gender, body mass index, height, weight), clinical (pain history, and...

We aimed to analyze potential correlations between S-LANSS and PainDETECT with proxies for pain sensitization, e.g., the Central Sensitization Inventory (CSI) and pressure pain hyperalgesia (construct validity), pain-related or psychological variables (concurrent validity) in women with fibromyalgia (FMS). One-hundred-and-twenty-six females with FM...

Previous studies have reported the presence of muscle weakness in women with fibromyalgia syndrome (FMS) which is considered a risk factor for developing earlier disability and dependence during activities of daily life (ADL). We aimed to assess the relationship between hand grip force with sociodemographic, clinical, disease-specific, cognitive, a...

Background Ultrasound imaging (US) has shown to be a reliable and valid tool for assessing muscle morphology and quality. However, most studies have focused on asymptomatic populations. Objective To investigate intra- and inter-rater reliability estimates of muscle morphology and quality of cervical multifidus (CM) and short rotators (SR) in patie...

Objective The purpose of this study was to develop a data-driven Bayesian network approach to understand the potential multivariate pathways of the effect of manual physical therapy in women with carpal tunnel syndrome (CTS). Methods Data from a randomized clinical trial (n = 104) were analyzed, comparing manual therapy including desensitization m...

Background Participants’ previous experience with an intervention may be an important variable when conducting sham-controlled trials. Objective This study explored if previous experience with dry needling (DN) influenced blinding effectiveness and pain outcomes, after the application of DN in patients with neck pain. Design A preliminary randomi...

Objective To compare the clinical effects of needling interventions eliciting local twitch responses (LTRs) versus needling without eliciting LTRs when applied to muscle trigger points (TrPs) associated with spinal pain of musculoskeletal origin. Databases and data treatment Electronic databases were searched for randomized or non-randomized clini...

Objective: Some studies have reported the presence of histological alterations such as myofibers disorganization and abnormalities in the number and shape of mitochondria in patients with fibromyalgia syndrome (FMS). Although Ultrasound imaging (US) is used to quantitatively characterize muscle tissues, US studies in patients with FMS are lacking....

Semi-quantitative elastography is a promising imaging technique to evaluate tissue stiffness differences, providing data regarding relative stiffness differences between two targets. The aims of this study were to assess the validity, inter-examiner reliability and variability of semi-quantitative elastography for calculating strain ratios (SR) in...

Background Although changes in muscle morphology and quality in deep neck flexors seem to be clear in patients with whiplash-associated disorders (WAD), evidence for deep neck extensors is heterogeneous. In addition, most studies have used magnetic resonance imaging or computer tomography, which is not available for regular practice. Objectives To...

Objective Current evidence suggests that carpal tunnel syndrome (CTS) involves widespread pressure pain sensitivity as manifestion of central sensitization. This study aimed to quantify mechanisms driving widespread pressure pain hyperalgesia in CTS by using network analysis. Design Cross-sectional. Setting Urban hospital. Subjects 120 women wit...

Rehabilitative ultrasound imaging (RUSI) is used by physical therapists as a feedback tool for measuring changes in muscle morphology during therapeutic interventions such as motor control exercises (MCE). However, a structured overview of its efficacy is lacking. We aimed to systematically review the efficacy of RUSI for improving MCE programs com...

Objective The presence of altered nociceptive pain processing in patients with upper extremity tendinopathy/overuse injury is conflicting. Our aim was to compare pressure pain thresholds (PPTs) in symptomatic and distant pain-free areas between patients with upper extremity tendinopathy/overuse injury and controls. Methods Five databases were sear...

Objective: Dry needling is commonly used for the management of musculoskeletal pain patients. However, the effects of patient expectations are uncertain. Our aim was to determine the effect of patient expectations on short-term clinical outcomes after the application of a single session of dry needling in individuals with neck pain. Methods: We...

The abdominal drawing-in maneuver (ADIM) is a clinical tool used for identifying preferential activity of deep abdominal muscles. However, concurrent validity and reproducibility of palpation during the ADIM has not been formally investigated. The aims of this study were (1) to assess intra- and interrater reliability of manual palpation during the...

It has been suggested that Percutaneous Electrical Nerve Stimulation (PENS) can increase muscle strength. No previous study has investigated changes in performance in semiprofessional soccer players. This study compares the effects of adding two sessions of PENS to a training program versus the single training program over sport performance attribu...

Background: Elastography is a promising imaging technique for evaluating various musculoskeletal tissues which uses acoustic radiation force pulse sequences to generate shear waves, which propagate perpendicular to the ultrasound beam causing transient displacements to calculate the tissues stiffness. Objective: The aims were to assess the validity...

Objective: To evaluate the effects of combining dry needling with other physical therapy interventions versus the application of the other interventions or dry needling alone applied over trigger points (TrPs) associated to neck pain. Databases and Data Treatment. Electronic databases were searched for randomized controlled trials where at least o...

Background In addition to muscle morphology, ultrasound imaging (US) could be a potential tool to determine muscle quality assessing the echo-intensity and using offline software to quantify the percentage of intramuscular fatty infiltration. Objective To investigate intra- and inter-rater image measurement reliability of morphological (i.e., cros...

Facial anatomical structures are not easily accessible to manual palpation. The aim of our study is to objectively assess temporomandibular joint and perimandibular muscles dimensions by means of sonographic measurements before and after dry needling (DN) in asymptomatic subjects. Seventeen subjects participated in this before-after study with a wi...

Objective The purpose of this study was to evaluate the effects of trigger point (TrP) dry needling alone or as an adjunct to other interventions on pain intensity and related disability in nontraumatic shoulder pain. Methods Ten databases were searched from inception to January 2020 for randomized clinical trials in which at least 1 group receive...

Background: Running often leads to several injuries. Mostly, injured joints in runners involve lower limbs: the foot district frequently is affected. However, Physical Therapists (PT) in a direct access setting may encounter patients with extra-expertise clinical conditions, such as fracture of the fifth metatarsal base mimicking ankle sprain. Case...

Objective To evaluate the effects of ultrasound-guided percutaneous electrolysis alone or as an adjunct to other interventions on pain and pain-related disability for musculoskeletal pain conditions. Databases and Data Treatment Search of MEDLINE database, Allied and Complementary Medicine Database, EMBASE database, Cumulative Index to Nursing & A...

Objective: Patients with ulnar neuropathy usually experience sensory disturbances, weakness, and decreased function; however, optimal treatment approaches for this condition are not conclusive. Case Description: A 48-year-old male with cubital tunnel syndrome was previously managed with a multimodal approach including splinting, neural mobilization...

Background Tendon dry needling is a potential treatment for tendinopathies. Several hypotheses have been proposed to explain its underlying mechanisms. No studies (to the best of our knowledge) have investigated changes in gene expression. Objective To investigate histological and gene expression changes after the application of dry needling to th...

Panoramic ultrasound (US) is a novel method used to assess linear dimensions, cross-sectional area, fatty infiltrate and echo-intensity features of muscles that cannot be measured with B-mode US. However, a structured overview of its validity and reliability is lacking. MEDLINE, PubMed, SCOPUS and Web of Science databases were systematically search...

Imaging findings in patellar tendinopathy are questioned. The aim of this pilot study was to characterize ultrasound measures, by calculating ultrasound ratio and neovascularization of the patellar tendon in non-elite sport players with unilateral painful patellar tendinopathy. Cross-sectional area (CSA), width, and thickness of the patellar tendon...

Percutaneous electrolysis is an emerging intervention proposed for the management of tendinopathies. Tendon pathology is characterized by a significant cell response to injury and gene expression. No study investigating changes in expression of those genes associated with collagen regeneration and remodeling of extracellular matrix has been conduct...

Previous studies analyzing morphometry of posterior cervical muscles with ultrasound (US) imaging have mainly used Brightness mode (B-mode). Our aim was to investigate the intra-examiner reliability of panoramic US imaging for assessing posterior-lateral cervical muscle layers. Panoramic US images of the neck at C4/C5 level were acquired in 25 asym...

Background: Studies analyzing morphometry of neck extensor musculature have mostly used Magnetic Resonance Imaging (MRI). Panoramic Ultrasound View could be used for obtaining high-quality 2D cross-sectional images with a wide field of view more cost-effectively imaging acquisition by creating an automatic construction of 2D cross-sectional images...

Objectives: To compare the effects of spinal thrust-manipulation and electrical dry needling (TMEDN-group) to nonthrust peripheral joint/soft-tissue mobilization, exercise and interferential current (NTMEX-group) on pain and disability in patients with subacromial pain syndrome (SAPS). Design: Randomized, single-blinded, multi-center, parallel-g...

Objective: No study has investigated the effects longer than 1-year of manual therapy in carpal tunnel syndrome (CTS). The purpose of this study was to investigate the effects of manual therapy versus surgery at 4-year follow-up and to compare the post-study surgery rate in carpal tunnel syndrome CTS. Methods: This randomized controlled trial wa...

Neuromuscular disorders (NMD) lead to the progressive loss of motor and respiratory functions and a decline in daily activities and participation. We aimed to evaluate respiratory changes and functional outcomes in children attending an aquatic therapy program. Eleven patients diagnosed with NMD (4–18 years, Vignos scale 1–9) were involved in a 10-...

Carpal tunnel syndrome is the most common nerve compression disorder of the upper extremity, and it is traditionally considered a peripheral neuropathy associated with a localized compression of the median nerve just at the level of the carpal tunnel. Surgery and physiotherapy are treatment approaches commonly used for this condition; however, conf...

Headache is the clinical syndrome most commonly observed by neurologists in daily practice. Pharmacological and non-pharmacological treatments are commonly used for the management of headaches; however, the clinical reasoning behind these interventions is not properly applied. We conducted a narrative literature review using as data sources for aca...

This study was conducted to investigate if anthropometric features can predict the depth of the soleus muscle, as assessed with ultrasound imaging, in a sample of healthy individuals to assist clinicians in the application of dry needling. A diagnostic study to calculate the accuracy of a prediction model for soleus muscle depth, as assessed with u...

Background Evidence suggests that medial pterygoid muscle plays an important role in temporomandibular pain. Therapeutic approaches targeting this muscle are needed. Objective To determine if a solid needle accurately penetrates the medial pterygoid muscle during the application of dry needling. Design A cadaveric and human descriptive study. Me...

Objective The aim of this study was to compare the effects of dry needling (DN) versus pressure release over scalene muscle trigger points (TrPs) on pain, related disability, and inspiratory vital capacity in individuals with neck pain. Methods In this randomized, single-blind trial, 30 patients with mechanical neck pain and active TrPs in the sca...

Background and objective: To evaluate the effects of percutaneous electrical stimulation (PENS) alone or as an adjunct with other interventions on pain and related-disability in musculoskeletal pain conditions. Databases and data treatment: Search of MEDLINE, EMBASE, AMED, CINAHL, EBSCO, PubMed, PEDro, Cochrane Library, SCOPUS and Web of Science...

Background Studies have analyzed muscle morphometry of cervical multifidus by using ultrasound imaging, but its reliability is not clearly determined. Objective To investigate intra- and inter-rater reliability of imaging capturing (probe assessment/patient positioning) and imaging calculation (scan assessment) of cervical multifidus cross section...

Objectives To determine the presence of post-needling induced pain in subjects who had suffered a stroke and received trigger point (TrP) dry needling (DN), and to investigate the effects of including TrP-DN into a rehabilitation program for shoulder pain in this population. Methods A randomized clinical trial was conducted. Sixteen patients who h...

Objective: The purpose of this study was to assess the effectiveness of the application of kinesio taping in reducing induced pain after dry needling of active trigger points (TrPs) to the upper trapezius muscle. Methods: Consecutive patients had mechanical neck pain (n = 34, 44% female) with active TrPs in the upper trapezius muscle. All partic...

Currently, aquatic exercise is among the most common physical activity modalities for children with neuromuscular and neurodevelopmental disorders. However, the outcome measures that should be routinely used by therapists working in this specific health-care context have not been widely studied. The purpose of the study was to identify and compare...

Background: Evidence suggests that suboccipital musculature plays an important role in headache. Proper therapeutic approaches targeting this muscle are needed. Objective: Our aim was to determine with fresh cadavers and ultrasound imaging if a solid needle is able to properly penetrate the obliquus capitis inferior muscle during the application...

Objective: To investigate the effects of the inclusion of neural mobilization into a motor control exercise program on pain, related-disability, neuropathic symptoms, straight leg raise (SLR), and pressure pain threshold (PPT) in lumbar radiculopathy. Design: A randomized clinical trial. Methods: Individuals with LBP, with confirmed disc herni...

Objective To assess the influence of clinical, psychological and psychophysical variables on long‐term clinical outcomes after the application of either physical therapy or surgery in women presenting with carpal tunnel syndrome (CTS). Methods A secondary analysis of a randomized trial investigating the efficacy of manual therapy including desensi...

Physical therapists employ ultrasound (US) imaging technology for a broad range of clinical and research purposes. Despite this, few physical therapy regulatory bodies guide the use of US imaging, and there are limited continuing education opportunities for physical therapists to become proficient in using US within their professional scope of prac...

Background: Patients with lateral elbow pain are often diagnosed with lateral epicondylalgia. Lateral elbow pain is often associated with dysfunction of the wrist extensor muscles; however, in some cases, it can also mimic signs and symptoms of radial nerve dysfunction. Case description: In this case report, a 43-year-old man, who was originally...

Featured Application This pilot study/systematic review provides an opportunity to improve the methodology of the research group, identify gaps or pitfalls to avoid, and develop a posterior and complete systematic review with no limitations that is the best application in order to begin using Cochrane’s guidelines. Abstract Background: Research of...

Background: Carpal tunnel syndrome (CTS) results in substantial societal costs and can be treated either by nonsurgical or surgical approaches. Objective: To evaluate differences in cost-effectiveness of manual physical therapy versus surgery in women with CTS. Methods: In this randomized clinical trial, 120 women with a clinical and an electr...

The purpose of this study was to assess and compare with rehabilitative ultrasound imaging (RUSI) the perimuscular connective tissue (PMCT) and interrecti distance (IRD) between elite and amateur basketball players. A sample of 22 healthy basketball players was included and divided into two groups: elite basketball players from Spanish 1st division...

Study Design Randomized, single-blinded, multi-center, parallel-group trial. Objectives To compare the effects of adding electrical dry needling into a program of manual therapy, exercise and ultrasound on pain, function and related-disability in individuals with plantar fasciitis (PF). Background The isolated application of electrical dry needli...

Plantar fasciitis trial study protocol. (PDF)

Appendix 1: Description of electrical dry needling, manual therapy and exercise interventions. (PDF)

Objective: The purpose of the current randomized clinical trial was to examine the effects of cervical thrust manipulation or sham manipulation on cervicocephalic kinaesthetic sense, pain, pain-related disability, and pressure pain sensitivity in patients with mechanical neck pain. Methods: Fifty-four individuals with neck pain were randomly ass...

Background The scientific evidence generated since Ikai & Fukunaga¹ began to use other than conventional ultrasound has resulted in a technique in Ultrasound for physiotherapy. This fact was duly noted at the first Symposium in San Antonio, Texas in 2006 and published in the JOSPT by Dr. Dreyde Tehyen.² As a result of these findings, we devised a d...

Background The painful shoulder is, concerning the frequency, the third reason for consultation in primary care. A recent review of epidemiological studies estimated incidence among 9–25 cases per 1000 habitants/year, the prevalence/point between 69 to 260 per 1000 habitants and prevalence/year between 47–467 cases per 1000 habitants. These numbers...

Background For the temporomandibular joint (TMJ) dry needling (DN) treatment is very useful, because of the reduced space of facial structures, that difficulty allow manual therapies. However, while it’s confirmed to be effective in relieving pain and tenderness, studies about its effects on healthy TMJ are lacking. To objectively assess the effect...

Background Patellar tendinopathy is highly prevalent in soccer. Chronic patellar tendinopathy can lead to calcific deposits in the tendon which will turn in a disabling situation. This case report shows the long-term outcomes of a professional soccer player presenting with intractable calcification in the patellar tendon receiving ultrasound-guide...

Background About 8,9% of the Spanish population play racket sports were the most prevalent injured anatomic area is the triceps surae. The only known predictor is that the mean age of patients is 40 years old. It would be useful to know the incidence and type of injury in these sports in order to establish mechanisms for prevention. Methods The ai...

Background The use of ultrasound among Spanish physiotherapists has grown in recent years. Methods On-line survey of 145 physical therapists spanish. Results A sample of 145 physical therapists (PTs) was recruited from 20 different geographical areas (figure 1). The time mean ±SD since subjects obtained their PT degree, started their ultrasonogra...

Background There is an incidence of 1 per 10 000 people suffering collateral ligament sprain per day. In healthy people there is no difference, but in teenager sport practice, females have prevalence than males in ankle sprains production. 85% of ankle sprains are of the collateral ligament, because it usually happens by a varus or valgus with flex...

Background The WHO states that a maximum of 10% of the daily total caloric intake should correspond to the consumption of free sugars. It has been described in a theoretical way that an excessive intake of free sugars may originate, on the one hand, a pancreatic affectation, and on the other hand, an impairment of the connective tissue. Therefore,...

Background Dry needling is therapeutic approach targeting myofascial trigger points. The application of dry needling into muscle strain is a controversial clinical topic. The application of dry needling under ultrasound guide may help to more precise therapeutic action of the needle. The current case report shows the long-term outcomes of a patient...

Objective To compare the effectiveness of trigger point dry needling (TrP-DN) versus placebo needling, relative to an untreated control group, on pain and quality of life in primary dysmenorrhoea. Methods In this randomised, single blind, parallel-group trial, 56 females with primary dysmenorrhoea were randomly allocated to TrP-DN (n=19), placebo...

This randomized clinical trial compared the effects of adding ultrasound (US)-guided percutaneouselectrolysis into a program consisting of manual therapy and exercise on pain, shoulder-related disability, function, and pressure sensitivity in subacromial pain syndrome. Fifty patients with subacromial pain syndrome were randomized into manual therap...

Objective: To evaluate the cost-effectiveness of the inclusion of trigger point-dry needling (TrP-DN) into an exercise program for the management of subacromial pain syndrome. Methods: Fifty patients with unilateral subacromial pain syndrome were randomized with concealed allocation to exercise alone or exercise plus TrP-DN. Both groups were ask...

Study Design Clinical measurement study. Background Achilles tendinopathy is a prevalent sport-related injury. The Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire is a widely used patient-reported outcome to assess the severity of symptoms for this injury. Objective To adapt the VISA-A questionnaire into Spanish and to ass...

Objective: To investigate somato-sensory nerve fibre function by applying different quantitative sensory testing including thermal, mechanical and vibration thresholds over latent trigger points (TrP) and in its associated referred pain area. Methods: A total of 20 subjects with unilateral latent TrPs in the extensor carpi radialis brevis were i...

Objective: People with migraine present with varying pain extent and an expanded distribution of perceived pain may reflect central sensitization. The relationship between pain extent and clinical features, psychological outcomes, related-disability and pressure pain sensitivity in migraine has been poorly investigated. Our aim was to investigate...

Study Design Randomized controlled trial. Background Evidence suggests that multimodal interventions that include exercise therapy may be effective for patellofemoral pain (PFP); however, no study has investigated the effects of trigger point (TrP) dry needling (DN) in people with PFP. Objectives To compare the effects of adding TrP DN to a manua...