Dry Needling vs. Stretching for Non-Specific Low Back Pain
- Conditions
- Non Specific Low Back Pain
- Registration Number
- NCT06756776
- Lead Sponsor
- Riphah International University
- Brief Summary
Chronic low back pain (CLBP) is one of the common health issues and a leading cause of reduced mobility. It is characterized by pain during functional activities and is often associated with hamstring tightness. CLBP affects individuals across all age groups. Various methods are used to address low back pain, including manual therapy. Manual therapy techniques include Maitland mobilizations, Kaltenborn mobilizations, Mulligan techniques, stretching, and others.
Several stretching techniques have been proposed, including static stretching, dynamic stretching, ballistic stretching, and proprioceptive neuromuscular facilitation (PNF). Among these, static and dynamic stretching are the most commonly used methods. Static stretching is considered one of the safest and easiest techniques, which can be performed passively or actively. Literature supports that stretching improves muscle flexibility, provides relaxation, reduces pain, and increases the range of motion (ROM).
Dry needling is another physical intervention technique that has been utilized for patients with musculoskeletal disorders. Current literature supports the use of dry needling for trigger points in hamstring muscles, which is a contributing factor to low back pain.
The objective of this study is to compare the effects of dry needling and stretching combined with sustained natural apophyseal glides (SNAGs) on pain, ROM, muscle length, and disability in patients with non-specific low back pain.
A randomized clinical trial will be conducted at Hijaz Hospital using convenience sampling to recruit participants. Patients will be allocated into two groups (Group A and Group B) through simple random sampling using sealed opaque envelopes. After conventional treatment, Group A will receive SNAGs and stretching, while Group B will receive SNAGs and dry needling.
Outcome measures will include the goniometer for ROM, the Modified Oswestry Disability Index (MODI) for disability, the Numeric Pain Rating Scale (NPRS) for pain, and the Finger-to-Floor Distance Test for hamstring flexibility. These measures will be assessed at baseline, at the 2nd week, and after 4 weeks. Data will be analyzed using SPSS software (version 21).
The normality of the data will be assessed using the Shapiro-Wilk test. Based on the results, parametric or non-parametric tests will be used for within-group and between-group comparisons. SNAGs and dry needling will be evaluated for their effectiveness in treating non-specific low back pain.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 44
- minimum 3 months chronicity of low back pain
- with tight hamstrings and positive passive knee extension test (12)
- Chronic systemic bony and soft tissue diseases
- Recent history of trauma
- Degenerative joint diseases
- Psychiatrist diseases
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Primary Outcome Measures
Name Time Method Numeric Pain Rating Scale (NPRS) baseline, 2 weeks, and 4 weeks The patient's level of pain will be assessed using the Numeric Pain Rating Scale (NPRS), which ranges from 0 to 10. A score of 0 indicates "no pain," while a score of 10 represents the "worst pain imaginable." (19)
- Secondary Outcome Measures
Name Time Method Modified Oswestry Disability Index (ODI) (Urdu version) baseline, 2 weeks, and 4 weeks The Modified Oswestry Disability Index (ODI) (Urdu version) will be used to assess the patient's functional disability due to chronic low back pain at baseline (0 weeks) and after 4 weeks. The modified ODI has a reliability score of 0.90.
Passive knee extension test baseline, 2 weeks, and 4 weeks A study shows that the goniometer is reliable for measuring knee and elbow joint angles, with reliability values ranging from r = 0.67 to 0.70 (16). The purpose of the Passive Knee Extension Test (also known as the 90-90 Straight Leg Raise \[SLR\] hamstring test) is to assess the joint range of motion and the quality of its movement, particularly the 'end feel' of the joint. This test is commonly used to measure hamstring muscle tightness. A test-retest reliability study for this assessment shows a reliability range of 0.87 to 0.94, indicating high intra-rater reliability (21).
Fingertip to Floor distance test baseline, 2 weeks, and 4 weeks The finger-to-floor distance test can be used to assess spine stiffness and evaluate the effects of exercise on spine stiffness in individuals with spine disorders, such as ankylosing spondylitis and back pain. The reliability of the fingertip-to-floor test in patients with low back pain (LBP), assessed using the Intraclass Correlation Coefficient (ICC) and the Bland-Altman method, is excellent. After a functional restoration program, which includes daily exercises for flexibility, the test demonstrated good sensitivity to change, with an effect size of 0.87 and a Standardized Response Mean (SRM) of 0.97. The interobserver reliability of the fingertip-to-floor test is also high, with an ICC of 0.97 (unpublished data).
Trial Locations
- Locations (1)
Hijaz Hospital Lahore
🇵🇰Lahore, Punjab, Pakistan