Effectiveness of Dry Needling Technique for Lower Back Pain (LBP)
A study into the results of dry needling for people suffering from lower back pain.
At Bodyharmonix we have experience with people who live with lower back pain (LBP) from traumatic work-related injuries. In Australia, back pain is the most prominent reason for workers to claim compensation. It is the second highest reason for an employee to have a disability that makes them unable to work their usual job.
In 2015, 14% of employees in Australia, predominantly male, suffered from LBP (Konekt, 2015). We find that the dry needling technique to be an effective pain reliever, and stimulant for healing processes to begin.
Early intervention is critical for physical performance, improvement of quality of life and return to work.
However, injured employees often delay in seeking treatment (Konekt, 2016), due to the potential financial and psychosocial costs of time off work (e.g., depression, anxiety, and stress due to reduced work hours and less income; as well as a breakdown in personal relationships with family, workmates and friends in general; Sing & Diwan, 2013).
Today’s post presents an outline of an empirical study about the effectiveness of the dry needling technique in treating LBP; Gunn, C. C., Milbrandt, E. E., Little, A. S., & Mason, K. E. (1980). Dry needling of muscle motor points for chronic low-back pain: A randomized clinical trial. Spine, 5(3), 279-291.
Clinical Studies on Dry Needling
A randomised controlled study is the highest caliber of rigor for an experiment. The aim of the study was to determine the effectiveness of the clinics standard program of therapy for people experiencing LBP: physiotherapy, occupational therapy and remedial exercises. Dry needling technique was provided to one group of participants in addition to the standard therapy regime, and the control group simply maintained a program of standard therapy.
Clinical Studies Participants
The 56 British Columbian male participants in the study were aged from 20 to 60 years, though on average were just over 40 years of age. The choice of only having male participants was to control for the possibility of LBP due to gynaecological reasons. The researchers excluded any patients who were diagnosed with ‘psychosomatic backache’ or who had psychological symptoms that were prominent in their clinical care needs. They were selected for the study by referral from their physician, because they had been experiencing lower back pain (LBP) for at least 12 weeks following an industrial trauma. Their periods of disability ranged from 12 to 168 weeks, with an average of LBP for just over 6 months. None of the men had any long-term relief from their pain using non-surgical or surgical treatments.
Each of the participants had been receiving the standard treatment regime of the clinic for 8 weeks.
The Therapy Treatment
The ‘usual treatment’ at the clinic aimed to provide pain relief and to reduce muscle spasms, in turn improving posture and patterns of movement in the musculature. Also, patients at the clinic are given self-management education, such as being showing how to correctly lift and bend for tasks at work and in daily tasks.
The experimental group received dry needling at motor points of the lower spine, which were chosen according to neurophysiological principles. Acupuncture points tend to align with muscle motor points, which are defined as an area of skin above an innervated muscle. This can be accessed to stimulate the neurovascular hilus of a muscle or its zone of innervation (band). As the myoneural junctions of a fibre do not have a standard distribution of the length of the muscle, they gather in a specific area. It is the band of innervation at the motor end-plates, or fibres with large diameters, which host most junctions.
Muscles that were tender with manual palpitation were chosen for their motor points. While the motor points can be in slightly different locations form person to person, there is a standard pattern. The dry needling technique used applied traditional acupuncture needles of 3, 4 and 5cm with a 30 gauge. The longer needles were used on the the thicker muscles, or those that lay deep beneath the skin. The needles were stimulated with ‘pecking’ and ‘twirling’ movements, thought to be particular for mechanoreceptors as their membranes are activated by stretching.
For the current study, as well as mechanical stimulation, a 9v electrical intermittent charge was used on each needle for a few seconds, before stopping and starting again, across 15 minutes.
The dry needling technique was received once or twice a week across 10 treatments. Patients who responded quickly to the dry needle treatment received less sessions with dry needles. And for patients whose symptoms subsided although continued, received additional treatments. Overall, the most treatments received was 15 and in general all those receiving extra treatments had returned to work by this time. An average of 7.9 dry needling sessions were given per patient. Follow-up treatment of dry needling for their LBP happened 12 weeks after their physician had discharged them from the study, and again up to 61 weeks. On average follow-up treatments were received at 27 weeks.
The Results Found
The ANOVA analysis (using covariance) found that the dry needling group had significantly better results as compared to the control group which received only the standard treatment. By the final follow-up sessions of interventions, 28 of the 29 men in the dry needling group had returned to work, and only 10 of these were assigned to lighter duties. In contrast, for the control group, 18 of the 27 returned to work, with 14 of these given lighter duties, and 9 remained disabled. Men under the age of 30 had a better outcome of either treatment as compared to those over 30.
The study concluded that dry needling at the zone of innervation alleviated LBP for the male participants. The repeated dry needling and microtrauma of the electrical current could have led to scar tissue forming in the fibre which displaced the nociceptors, providing pain relief.
Some patients pain did not respond as well as others in the dry needling group and that’s because they were experiencing mechanical irritation from an unstable spine.
Bodyharmonix Therapeutic Treatments
It’s important to keep in mind that at Bodyharmonix we do not deliver electrical current during your therapy treatment session. You can find pain relief using our advanced techniques. Our staff are highly qualified to help you with this.
Another key service for those who experience pain due to unstable spine is our posture analysis. This will help us determine the root cause of your back problems.
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Konekt. (2015). Market report: Volume 2. Retrieved from, http://www.konekt.com.au/wp-content/uploads
Konekt. (2016). Market report: Volume 3. Retrieved from, http://www.konekt.com.au/wp-content/uploads
Singh, M. J., & Diwan, G. (2013). Backing up the stories: The psychological and social costs of chronic
low-back pain. International Journal of Spine Surgery, 7, 29-38. doi: 10.1016/j.ijsp.2013.02.001.
Charmayne Paul, Bodyharmonix Associate, of Psych and Stats Tutor ~ Chart your course to success~