Benefits of Adding Gluteal Dry Needling to a Four-Week Physical Exercise Program in a Chronic Low Back Pain Population. A Randomized Clinical Trial

Abstract

Objective To determine if adding dry needling to a four-week exercise program has an additional benefit compared with adding sham dry needling to the same exercise program in subjects with chronic low back pain. Design Randomized clinical trial. Setting Physiotherapy and Pain Clinic of Alcala University. Subjects Forty-six patients with chronic low back pain. Methods Subjects were randomized to two groups: the dry needling group (N = 23) or sham dry needling group (N = 23). Both groups received a four-week exercise program and before the exercise started a session of dry needling or sham dry needling. Pain (visual analog scale), disability (Roland-Morris Questionnaire), and fear avoidance beliefs (Fear Avoidance Beliefs Questionnaire) were assessed at baseline, after treatment, and at three-month follow-up. Pressure pain thresholds (algometer) were measured at baseline, after the dry needling or the sham dry needling, and after treatment. Results Both groups showed significant improvements for all variables. In the between-group comparison, the dry needling group improved significantly in pain at three-month follow-up and pressure pain thresholds at the end of treatment for all measures, and at three-month follow-up there was no improvement in gluteus medium. Conclusions In chronic low back patients, adding dry needling to a four-week exercise program has an additional benefit in pain and sensitivity compared with adding sham dry needling to the same exercise program.

Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Needling Therapies for Chronic Primary Low Back Pain in Adults

“…The RCTs were conducted in high-income economies [ 63 ]: Germany (5 RCTs) [ 26 , 32 , 41 , 52 , 53 ], Ireland (1 RCT) [ 34 ], Korea (2 RCTs) [ 28 , 47 ], Spain (1 RCT) [ 39 ], and the United States (6 RCTs) [ 27 , 36 , 40 , 55 , 62 , 64 ]; upper-middle income economies: Brazil (4 RCTs) [ 29 – 31 , 49 ] and China (15 RCTs) [ 33 , 37 , 38 , 37 – 38 , 37 – 38 , 54 , 37 – 38 , 37 – 38 ]; and lower-middle income economies: Iran (3 RCTs) [ 42 , 48 , 58 ]. The mean age ranged from 30 to 72 years; one RCT assessed older adults (n = 55) [ 40 ].…”

Clinical efficacy of acupuncture therapy combined with core muscle exercises in treating patients with chronic nonspecific low back pain: a systematic review and meta-analysis of randomized controlled trials

“…Hence, we excluded this study. Martín-Corrales et al control group was treated with a combination of sham-dry needling based on exercise, that is, without penetrating the skin, using Park sham needles (Park Sham Device, AcuPrime, UK) on the skin to induce a tingling sensation ( 54 ). However, exploring the therapeutic mechanism of acupuncture based on meridian research theories suggests that acupuncture points are rich in sensory nerve receptors and that stimulation of acupuncture points, manually or using low currents and frequencies, reportedly works through the connection of the central nervous system to the effector organs and the integrative function of neurons in the brain ( 55 ).…”

The effectiveness of dry needling in patients with chronic low back pain: a prospective, randomized, single-blinded study

“…For instance, Martín-Corrales et al 10 examined the DN effectiveness and measured the long-term effects of treatment in combination with a 4-week LBP exercise program. The participants were randomly assigned to the experimental DN (23 people) and sham-DN (23 patients) groups.…”