Which area may be important to include in the dry needling treatment based on the evidence?

Including the paraspinals of the innervating spinal level in dry needling treatment is important due to the interconnected nature of muscular and fascial systems in the body. The paraspinal muscles, which are located along the spine, play a significant role in supporting postural stability and spinal alignment. Dry needling in this area can directly affect the surrounding musculature and fascia, leading to improved neuromuscular function, reduced pain, and enhanced range of motion.

Evidence supports the targeting of these muscles for effective pain relief and functional improvement, particularly when considering a patient's specific symptoms that may stem from dysfunction or tightness in these regions. Additionally, treating the specific spinal levels that innervate symptomatic areas can potentially lead to broader therapeutic benefits throughout the body.

Other areas listed, such as the distal lower extremities, shoulders, and hands/wrists, may also play a role in dry needling practices, but they do not specifically address the central involvement of paraspinals and their innervating spinal levels in the context of referred pain and muscular dysfunction. The evidence strongly supports including the paraspinal area for targeted treatment based on its importance in pain management and functional restoration.