TITLE:
Dry Needling in the Treatment of Chronic Cerebrospinal Venous Insufficiency (CCSVI) Associated with Cervical Muscular Dysfunctions: A Case Report
AUTHORS:
Luca Gentili, Alessio Pederzoli, Giorgio Colagrossi, Riccardo Rosa, Giovanna Borriello
KEYWORDS:
Dry Needling, Cerebrospinal Venous Insufficiency, Multiple Sclerosis, Cervical Muscular Dysfunction, Myofascial Trigger Points
JOURNAL NAME:
Open Access Library Journal,
Vol.12 No.5,
May
29,
2025
ABSTRACT: Background: Chronic cerebrospinal venous insufficiency (CCSVI) involves impaired venous drainage of the central nervous system. Myofascial trigger points (TrPs) in neck muscles may contribute to venous obstruction through direct compression and altered biomechanics. Dry Needling (DN) effectively deactivates TrPs and reduces muscle hypertonicity, potentially improving venous outflow. Case: A 40-year-old man with relapsing-remitting multiple sclerosis presented with worsening neurological symptoms following cervical trauma from a surfing accident. Physical examination revealed marked cervical anteriorization, tense and painful sternocleidomastoid muscles bilaterally with palpable trigger points, and limited cervical mobility. Echo-color Doppler confirmed CCSVI with right jugular “bottleneck”. The patient underwent 8 weekly DN sessions targeting TrPs in cervical muscles. Follow-up assessments showed progressive normalization of venous flow, reduced headache frequency, improved fatigue scores (FSS-9 from 5.6 to 3.1), enhanced sleep quality, reduced pain (VAS from 7 to 2), and improved cervical mobility (+35%). Conclusion: This case demonstrates that DN can improve clinical symptoms and venous outflow in selected CCSVI patients with cervical muscular dysfunction. DN appears to address CCSVI’s muscular component through reduced mechanical compression and enhanced local circulation, warranting further investigation through controlled trials.