A randomized clinical trial comparing non-thrust manipulation with segmental and distal dry needling on pain, disability, and rate of recovery for patients with non-specific low back pain

ABSTRACT

Objective: The purpose of this study was to examine the within and between-group effects of segmental and distal dry needling (DN) without needle manipulation to a semi-standardized non-thrust manipulation (NTM) targeting the symptomatic spinal level for patients with non-specific low back pain (NSLBP).

Methods: Sixty-five patients with NSLBP were randomized to receive either DN (n = 30) or NTM (n = 35) for six sessions over 3 weeks. Outcomes collected included the oswestry disability index (ODI), patient specific functional scale (PSFS), numeric pain rating scale (NPRS), and pain pressure thresholds (PPT). At discharge, patients perceived recovery was assessed.

Results: A two-way mixed model ANOVA demonstrated that there was no group*time interaction for PSFS (p = 0.26), ODI (p = 0.57), NPRS (p = 0.69), and PPT (p = 0.51). There was significant within group effects for PSFS (3.1 [2.4, 3.8], p = 0.018), ODI (14.5% [10.0%, 19.0%], p = 0.015), NPRS (2.2 [1.5, 2.8], p = 0.009), but not for PPT (3.3 [0.5, 6.0], p = 0.20).

Discussion: The between-group effects were neither clinically nor statistically significant. The within group effects were both significant and exceeded the reported minimum clinically important differences for the outcomes tools except the PPT. DN and NTM produced comparable outcomes in this sample of patients with NSLBP.

Level of evidence: 1b

KEYWORDS:

• Low back pain
• manual therapy
• dry needling

Disclosure statement

David Griswold is an instructor for and Frank Gargano is the President of Integrative Dry needling.

Additional information

Notes on contributors

D. Griswold

David Griswold, DPT, PhD is an Associate Professor of Physical Therapy at Youngstown State University in Youngstown, OH. He received his DPT from Youngstown State University, PhD in Physical Therapy from Nova Southeastern University, and holds three nationally recognized certifications in  orthopedic manual therapy.  He is a national instructor for Integrative Dry Needling Institute Seminars.

F. Gargano

Frank Gargano, DPT, OCS has 29 years of experience as an Orthopedic Physical Therapist in private practice.  He provides continuing education seminars nationally and internationally on the topics of manual therapy, and  dry needling. He is the owner and President of the Integrative Dry Needling Institute.

K. E. Learman

Kenneth E. Learman, PT, PhD is a Professor of Physical Therapy at Youngstown State University in Youngstown, Ohio. He received his BSPT at SUNY- Bu alo, his MEd in Health Education at Penn State University and his PhD in Sports Medicine at the University of Pittsburgh. In addition, Ken is a board certified specialist in orthopedic physical therapy, a certifieded orthopedic manual therapist through Maitland-Australian Physiotherapy Seminars (MAPS), and a fellow in the American Academy of Orthopedic Manual Physical Therapists.