scholarly journals Dry Needling and Management of Trigger Points with Low Back Pain: An Evidence to Practice Review

2021 ◽  
Vol 4 (2) ◽  
pp. 21-25
Author(s):  
Matthew Drescher ◽  
Matthew Rivera ◽  
Lindsey Eberman
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Trigger Points ◽  
The Body ◽  
Health Concern ◽  
Low Back ◽  
Dry Needling ◽  
Myofascial Trigger Points

Low back pain is a common health concern. The development of myofascial trigger points due to low back pain can cause debilitating pain and loss of functional movement in patients. Dry needling is a minimally invasive procedure that has shown to be useful in the treatment of myofascial trigger points when used with other forms of treatment. However, the literature surrounding dry needling and myofascial trigger points in patients with low back pain is lacking. The guiding systematic review and meta-analysis sought to analyze the effectiveness of dry needling for patients with low back pain. The review utilized eight databases for randomized controlled trials and selected 11 of 784 articles for analysis based on inclusion and exclusion criteria. A 6-subgroup meta-analysis was conducted on these studies, and 6 of the 11 studies were found to have high risk of bias. The included studies used both pain measurements and functional measurements including the visual analogue scale (VAS), Oswestry Disability Index (ODI), and the Roland-Morris Disability Questionnaire (RDQ). The studies did not include objective functional measurements. Overall researchers found a clinically meaningful decrease in outcome scores in the short-term, but there were no significant differences in pain or functional outcomes through long-term follow-up. This seems to correlate with the current literature on dry needling and its inflammatory effects on the body, suggesting that dry needling alone does not provide any long-term effect on myofascial trigger points in patients with low back pain. Dry needling should be combined with other treatments and high-quality rehabilitation to provide longer-lasting results and better treatment outcomes for patients with low back pain.

scholarly journals Electrical Dry Needling Versus Conventional Physiotherapy in the Treatment of Active and Latent Myofascial Trigger Points in Patients With Nonspecific Chronic Low Back Pain

2021 ◽  
Author(s):  
Inmaculada C. Lara-Palomo ◽  
Esther Gil-Martínez ◽  
Eduardo Antequera-Soler ◽  
Adelaida María Castro-Sánchez ◽  
Manuel Fernández-Sánchez ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Trigger Points ◽  
Low Back ◽  
Dry Needling ◽  
Myofascial Trigger Points ◽  
Conventional Physiotherapy ◽  
The University

Abstract Background: Chronic low back pain is considered to be one of the main causes of absenteeism from work and primary and specialized consultations. The symptoms of non-specific chronic low back pain may be accompanied by the activation of myofascial trigger points in the muscles, together with local and/or referred pain. Electrical dry needling is increasingly used in the treatment of lumbar myofascial pain. Conventional physiotherapy, however, is a popular approach to chronic pathologies, and there is evidence of different modalities of physiotherapy being used in the treatment of chronic low back pain. The aim of this study has been to determine the effectiveness of electrical dry needling versus conventional physiotherapy when applied to active and latent myofascial trigger points in patients with nonspecific chronic low back pain. Methods and Analysis. This is a controlled, randomized, two-arm, double-blind study. A total of 92 patients with chronic low back pain (time to onset ≥ 3 months, Roland Morris Disability Questionnaire score ≥ 4) will be recruited from the University of Almería. Participants will be divided into two study groups (n = 40, respectively) to receive treatment of low back pain with electrical dry needling and conventional physiotherapy (ischaemic compression, analytic stretching and postural education training dossier). A total of 3 sessions will be administered once a week for 3 weeks. Pain intensity, disability, fear of movement, quality of life, quality of sleep, anxiety and depression, pressure pain threshold, abdominal strength, and lumbar mobility will be recorded at 3 weeks (post-immediate) and 2 months after the end of treatment.Ethics and dissemination. Ethics and Research Committee of the University of Almería (UALBIO2020/044). The results of the study will made available to researchers, clinicians and health professionals through publications in international journals and presentations in conferences.Trial registration number: NCT04804228. Recruiting

scholarly journals Intervertebral disc therapies for non-specific chronic low back pain: a systematic review and meta-analysis

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110280
Author(s):  
Camille Daste ◽  
Stéphanie Laclau ◽  
Margaux Boisson ◽  
François Segretin ◽  
Antoine Feydy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Intervertebral Disc ◽  
Chronic Low Back Pain ◽  
Meta Analysis ◽  
Activity Limitations ◽  
Low Back ◽  
Short Term

Objectives: We aim to evaluate the benefits and harms of intervertebral disc therapies (IDTs) in people with non-specific chronic low back pain (NScLBP). Methods: We conducted a systematic review and meta-analysis of randomized trials of IDTs versus placebo interventions, active comparators or usual care. EMBASE, MEDLINE, CENTRAL and CINHAL databases and conference abstracts were searched from inception to June 2020. Two independent investigators extracted data. The primary outcome was LBP intensity at short term (1 week–3 months), intermediate term (3–6 months) and long term (after 6 months). Results: Of 18 eligible trials (among 1396 citations), five assessed glucocorticoids (GCs) IDTs and were included in a quantitative synthesis; 13 assessed other products including etanercept ( n = 2), tocilizumab ( n = 1), methylene blue ( n = 2), ozone ( n = 2), chymopapaine ( n = 1), glycerol ( n = 1), stem cells ( n = 1), platelet-rich plasma ( n = 1) and recombinant human growth and differentiation factor-5 ( n = 2), and were included in a narrative synthesis. Standardized mean differences (95% CI) for GC IDTs for LBP intensity and activity limitations were −1.33 (−2.34; −0.32) and −0.76 (−1.85; 0.34) at short term, −2.22 (−5.34; 0.90) and −1.60 (−3.51; 0.32) at intermediate term and −1.11 (−2.91; 0.70) and −0.63 (−1.68; 0.42) at long term, respectively. Odds ratios (95% CI) for serious and minor adverse events with GC IDTs were 1.09 (0.25; 4.65) and 0.97 (0.49; 1.91). Conclusion: GC IDTs are associated with a reduction in LBP intensity at short term in people with NScLBP. Positive effects are not sustained. IDTs have no effect on activity limitations. Our conclusions are limited by high heterogeneity and a limited methodological quality across studies. Registration PROSPERO: CRD42019106336.

scholarly journals Myofascial trigger-point compression therapy as an adjunct to exercise program is superior in alleviating chronic low back pain compared to exercise program alone

2020 ◽  
Author(s):  
Rawan Masarwa ◽  
Ofir Uri ◽  
Givon Peled ◽  
Gil Laufer ◽  
Gabriel Gutman ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Exercise ◽  
Exercise Program ◽  
Compression Therapy ◽  
Trigger Points ◽  
Control Group ◽  
Low Back ◽  
Myofascial Trigger Points

Abstract Background Current guidelines for the treatment of low back pain (LBP) endorse physical exercise programs and a range of non-pharmacological complementary therapies. Myofascial trigger points (MTrPs) compression therapy is a well-established form of manual therapy, which aims to induce temporary ischemia and over-stimulation of mechanoreceptors over a desired area in order to restore tissue normal functional conditions required for healing response. The purpose of the current study was to evaluate the effect of MTrPs compression therapy as an adjunct to active exercise program in alleviating chronic non-specific low back pain. Methods One-hundred and three patients with chronic non-specific LBP were retrospectively reviewed, 45 of them were treated with MTrPs compression therapy as an adjunct to physical exercise program (MTrPs group) and 58 were treated with exercise program alone (control group). Pain and functional scores were compared before initiating treatment and at 3-month follow-up. Results Pain reduction at 3-month follow-up was 5.6 points (0–10 numerical scale) in the MTrPs group compared to 3.6 points in the control group (p < 0.001). Oswestry Disability Index and SF-12 life quality scores also improved significantly more in the MTrPs group compared to the control group at 3-month follow-up (p < 0.001). Conclusions Myofascial trigger points compression therapy as an adjunct to active exercise program provides superior pain and disability relief to patients with chronic LBP compared to active exercise program alone.

EPIDURAL STEROID INJECTION THERAPY FOR LOW BACK PAIN: A META-ANALYSIS

2013 ◽  
Vol 29 (3) ◽  
pp. 244-253 ◽  
Author(s):  
Hyun Jin Choi ◽  
Seokyung Hahn ◽  
Chi Heon Kim ◽  
Bo Hyoung Jang ◽  
Soyoung Park ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Steroid Injection ◽  
Meta Analysis ◽  
Epidural Steroid Injection ◽  
Low Back ◽  
Number Of Patients ◽  
Epidural Steroid

Objectives: The aim of this study was to systematically assess the long-term (≥ 6 months) benefits of epidural steroid injection therapies for patients with low back pain.Methods: We identified randomized controlled trials by database searches up to October 2011 and by additional hand searches without language restrictions. Randomized controlled trials on the effects of epidurals for low back pain with follow-up for at least 6 months were included. Outcomes considered were pain relief, functional improvement in 6 to 12 months after epidural steroid injection treatment and the number of patients who underwent subsequent surgery. Meta-analysis was performed using a random-effects model.Results: Twenty-nine articles were selected. The meta-analysis suggested that a significant treatment effect on pain was noted at 6 months of follow-up (weighted mean difference [WMD], −0.41; 95 percent confidence interval [CI], −0.66 to −0.16), but was no longer statistically significant after adjusting for the baseline pain score (WMD, −0.19; 95 percent CI, −0.61 to 0.24). Epidural steroid injection did not improve back-specific disability more than a placebo or other procedure. Epidural steroid injection did not significantly decrease the number of patients who underwent subsequent surgery compared with a placebo or other treatments (relative risk, 1.02; 95 percent CI, 0.83 to 1.24).Conclusions: A long-term benefit of epidural steroid injections for low back pain was not suggested at 6 months or longer. Introduction of selection bias in the majority of injection studies seems apparent. Baseline adjustment is essential when we evaluate pain as a main outcome of injection therapy.

scholarly journals Myofascial Trigger Points, Pain, Disability, and Sleep Quality in Patients with Chronic Nonspecific Low Back Pain

Pain Medicine ◽  
2013 ◽  
Vol 14 (12) ◽  
pp. 1964-1970 ◽  
Author(s):  
Juan J. Iglesias-González ◽  
María T. Muñoz-García ◽  
Daiana P. Rodrigues-de-Souza ◽  
Francisco Alburquerque-Sendín ◽  
César Fernández-de-las-Peñas
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Sleep Quality ◽  
Trigger Points ◽  
Low Back ◽  
Myofascial Trigger Points ◽  
Pain Disability
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