Percutaneous Electrical Nerve Stimulation Versus Dry Needling: Effectiveness in the Treatment of Chronic Low Back Pain

ABSTRACT

Objective: The aim of this study was to evaluate the effectiveness of treating myofascial trigger points [TrPs] with dry needling [DN] compared to percutaneous electrical nerve stimulation [PENS].

Method: In this clinical trial, 122 subjects suffering from non-specific chronic low back pain [CLBP] were treated. They were randomly distributed into two treatment groups: one taking PENS and the other taking DN of TrPs on the deep lumbar paraspinal muscles [lumbar multifidi], quadratus lumborum, and gluteus medius. Four variables were measured: perceived pain and sleep quality using a visual analog scale [VAS], pressure-pain tolerance threshold on TrPs with an algometer, and quality of life assessed with the Oswestry Disability Index.

Results: At least one TrP was found in all patients, most commonly situated in the quadratus lumborum muscle [97.6 percent]. The improvement achieved for both treatment groups was similar in all the measured variables, although the DN group carried out fewer sessions than the PENS group.

Conclusions: It could be concluded that the effectiveness of DN is comparable to that of PENS and, therefore, it may be considered as another useful tool with limited adverse effects within the multidisciplinary approach required in the management of non-specific CLBP.

KEYWORDS. :

• Chronic low back pain
• Trigger points
• PENS
• Dry-needling
• Myofascial pain syndrome

ACKNOWLEDGEMENTS

The authors would like to thank Eva Andrés for her expert advice on statistics, and Jesús Magdalena, J.M. Vergara, and Orlando Mayoral for their scientific and methodological commentaries. The work was supported by the Aragonese Health Service (Spain) and Research Network on Preventive Activities and Health Promotion (Health Institute Carlos III) and Aragonese Health Science Institute.

Declaration of interest: The author reports no conflict of interest. The author alone is responsible for the content and writing of this paper.