Effectiveness of dry needling versus a classical physiotherapy program in patients with chronic low-back pain: a single-blind, randomized, controlled trial.
Emİne Handan Tüzün, Sıla Gıldır, Ender Angın and 3 others
PMID 28931976WHAT IT FOUND
Dry needling plus massage reduced pain, trigger points, and sensitivity more than hot pack, TENS, ultrasound, and exercises after six sessions.
The needling and massage cannot be separated.
Key findings
01Pain measured on the visual analog scale improved in both groups, and the after-treatment comparison favoured the dry needling and massage group.
02The dry needling and massage group had fewer trigger points and lower trigger point sensitivity than the control group after treatment.
03Depression scores did not differ significantly between groups after treatment, and fear of movement favoured the dry needling and massage group with small to medium effect sizes.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 18 participants were analysed in the dry needling and massage group and 16 in the control group. Only the evaluator was blinded to treatment groups. The dry needling group also received classic massage, so the effect of dry needling alone cannot be separated. The control group also received hot pack, TENS, ultrasound, and home exercises together, so the effect of any one control treatment cannot be separated. There was no no-treatment control group, so the study cannot tell whether improvements were due to the treatments or to something else. There was no follow-up, so the trial does not show how long the effects lasted. Two control group participants were excluded because they had no active or latent trigger point. The home exercise program was a standard set of exercises, not individualised to each patient's disc pathology.
The easy way to misread this
Do not conclude that dry needling alone caused the improvement. The experimental group received dry needling and classic massage together, and the control group received hot pack, TENS, ultrasound, and home exercises together, so the contribution of any single component cannot be separated.