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

Abstract

Dry needling (DN) is a standard procedure for treating musculoskeletal disorders. However, there are no clear recommendations for using DN in low back pain (LBP). Therefore, this study aimed to assess the effectiveness of the novel DN program for reducing pain intensity and improving functional efficiency in patients with chronic LBP. A group of 40 patients with chronic LBP due to the L5-S1 discopathy were eligible and randomized into experimental (n = 20) and control (n = 20) groups. The DN program was performed for the experimental group according to the Five Regulatory Systems (FRS) concept. The control group received sham therapy using placebo needles. DN sessions were performed twice a week for 4 weeks. A single needling application lasted 60 min. Both groups received standard treatment and physical exercise of LBP for 1 month. Subjective pain was measured by a visual analog scale (VAS), functional efficiency was assessed with the Oswestry Disability Index (ODI), and the lower spine range of motion was measured with the Schober test. There were significant differences in pain reduction (VAS) in both groups (p < 0.001). The strongest analgesic effect in the DN group yielded 6.45 points immediately after the therapy, 6.2 points after 1 month, and 6 points after 3 months. The DN group scored higher VAS reduction than the control group (p < 0.001). There were significant differences in the functional state (ODI) in the experimental group (p < 0.001). There was a significant ODI decrease by 18.1 points, after 1 month by 18.9 points, and after 3 months by 17.6 points. No significant differences were found in the control group (p > 0.05). Intergroup differences were observed in the functional efficiency in ODI in all measurement time-points (p < 0.001). There were significant differences in the range of motion (Schober test) in the DN group (main effect: p < 0.001). For all measurements, differences (p < 0.001) were observed in favor of DN compared to the control. In conclusion, DN program according to the FRS concept stands for the novel treatment method supplemented by an exercise program, effectively reducing pain and improving functional efficiency in LBP patients.

Duration of Electro-Dry Needling Does Not Change the Pain Response After Repeated Nociceptive Thermal Stimuli in Asymptomatic Individuals: A Randomized Intervention Study

“… 10 , 11 , 47 It is not uncommon to see investigations where needle retention time varies from less than 10 minutes, 48 to 20 minutes, 4 or even up to 60 minutes. 49 What's remarkable is that despite the variation, each of the above studies reported decreases in pain and disability after DN. While needle retention time is just a single component of the overall dosage parameters for EDN, being able to use the same amount of time across studies can help better inform clinicians and provide a basis for future studies.…”

A Systematic Review and Meta-Analysis Protocol on How Best to Use Non-Pharmacologic Therapies to Manage Chronic Low Back Pain and Associated Depression

“…The secondary outcomes will include: Total effective rate (as a dichotomous outcome): defined as the proportion of participants with a clinically relevant improvement according to a predefined change in validated depressive symptom and pain intensity rating scales at the end of the treatment period. Back pain-related function: measured as a continuous variable on any validated scale such as the Roland-Morris Disability Questionnaire (RMDQ), 32 Oswestry Disability Index (ODI), 33 Hanover Functional Ability Questionnaire (HFAQ), 34 or other rating scale with evidence of adequate validity and reliability at the end of the treatment period. Health-related Quality of Life (HRQoL): measured as a continuous variable on any validated HRQoL scale such as the Medical Outcomes Study 36/12-Item Short-Form Health Survey (SF-36/12), 35 , 36 Brief Form of the World Health Organization’s Quality of Life Questionnaire (WHOQOL-BREF), 37 Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), 38 Nottingham Health Profile (NHP), 39 or other well-recognized HRQoL scales with evidence of adequate validity and reliability at the end of the treatment period.…”

“…2. Back pain-related function: measured as a continuous variable on any validated scale such as the Roland-Morris Disability Questionnaire (RMDQ), 32 Oswestry Disability Index (ODI), 33 Hanover Functional Ability Questionnaire (HFAQ), 34 or other rating scale with evidence of adequate validity and reliability at the end of the treatment period. 3.…”

Effects of different treatments on pain, functional disability, position sense and range of motion in elite bodybuilders with chronic low back pain

“…So far, many studies have investigated different treatment approaches for non-specific chronic low back pain 10 – 13 . Although there are many contradictions, such as the degree of effectiveness and their possible side effects, regarding the selection of the most favorable treatment approach, there is an agreement that such advices as bed rest, which were previously recommended for acute back pain, are not very effective for this type of back pain 10 , 11 .…”

“…Although there are many contradictions, such as the degree of effectiveness and their possible side effects, regarding the selection of the most favorable treatment approach, there is an agreement that such advices as bed rest, which were previously recommended for acute back pain, are not very effective for this type of back pain 10 , 11 . Based on the research findings, various treatment approaches have been used to treat back pain, including drug therapy 12 , dry needling 13 , 14 , kinesiotaping 15 , 16 , laser therapy 17 , 18 , massage, hydrotherapy 19 , 20 , ultrasound 21 , 22 , and finally surgery 23 – 25 . Based on these studies [], it has been determined that each of these treatment methods can have immediate or delayed effects on the recovery of people with low back pain.…”