What You Need to Know About Dry Needling for Low Back Pain

Myofascial trigger points are among the most common forms of low back pain. When activated, these tender and stiff “knots” of bundled spinal muscles can reduce your range of motion and cause referred pain—that is, pain that spreads—such as from your low back into one or more areas of the hip, groin, abdominal, gluteus muscles, tailbone, and/or thigh. An emerging treatment for trigger points is dry needling, and research published in 2018 said this manual technique may effectively treat trigger point-related low back pain when coupled with other therapies.1

What is dry needling?

During a dry needling session, a clinician injects thin filiform needles (the same type of needle commonly used in acupuncture) into a trigger point. The goal is to “deactivate” the trigger point. We all have trigger points, but they only cause symptoms when they’re active. When the trigger point is deactivated, you’ll experience an increase in range of motion and function, and a decrease in pain.
Removing acupuncture needle from packaging.It is thought that dry needling therapy stimulates blood flow to the trigger point to ease muscle contraction and subsequently, pain. Photo Credit: 123RF.com.

How does dry needling deactivate trigger points?

Researchers still aren’t exactly sure how, but they believe the therapy stimulates blood flow to the trigger point to ease muscle contraction. Some hypothesize that dry needling also helps block pain signals.

Because it relies on needles to stimulate a response, many people associate dry needling with acupuncture—but the 2 therapies are distinct. The goal of acupuncture is to unblock the body’s energy—called Qi—and move it through the body’s systems (ie, nervous, circulatory, muscular, etc.). Dry needling does not follow acupuncture’s ancient philosophy, as it focuses more on the targeted treatment of nerve and muscle pain.

While this therapy is most known for easing trigger point pain throughout the spine, practitioners have used it for a variety of other conditions, including carpal tunnel syndrome and cervicogenic headaches.

Different clinicians practice dry needling, including physical therapists, chiropractors, acupuncturists, nurses, and doctors.

Research: Dry Needling Works Best With Other Low Back Pain Treatments

In 2018, researchers reviewed the available evidence on dry needling to understand how effective the therapy is at treating trigger points that cause low back pain. They found that scientific evidence linking dry needling to reduced low back pain was lacking. However, they were able to draw some conclusions from the small sample of studies they reviewed.

“The low-to-moderate-quality evidence showed that compared with other treatments, dry needling resulted in significant reduction in pain intensity and functional disability at post-intervention,” wrote the researchers. “However, dry needling plus other treatments for [low back pain] was more effective than dry needling alone in pain intensity reduction at post-intervention, but the quality of evidence was low.”1

Other forms of treatment analyzed in the study included acupuncture, standard physical therapy, and local anesthetic injection therapy.

A resource paper produced by the American Physical Therapy Association (APTA) called “Description of Dry Needling in Clinical Practice” echoed the findings of the researchers, noting that "DN [dry needling] is rarely a stand-alone procedure and should be part of a broader physical therapy approach." The APTA recommends pairing dry needling with other manual therapies and exercises for best results, in addition to increased education for patients on how they can keep their muscles healthy between dry needling and physical therapy sessions (eg, through at-home stretching or the use of heat therapy).2

What should I know before my dry needling session?

You do not need to do any special preparation before a dry needling session. Many people experience immediate relief from symptoms after their session (though the length of relief may vary—from hours up to weeks). You should ask your physical therapist or clinician who performs your dry needling, if you should follow treatment with an ice pack (“icing”) versus heat, such as a heating pad.

You may be sore in your trigger point areas after treatment, which is normal. Talk with your practitioner about taking supplements, such as turmeric and arnica to help reduce swelling and possibly bruising after dry needling therapy.

Also, your practitioner will likely recommend not returning for a repeat treatment in the same location within 72 hours to give your tissues enough time to heal. Despite some lingering soreness, you’ll likely be able to drive home or return to work right after your dry needling session. For optimal results, you should participate in a treatment plan that combines dry needling with other treatments (eg, other physical therapy modalities or spinal injection therapy) for a 6-week period.3

Many people are seeking new and safe alternatives to treat their low back pain, and dry needling may be part of the solution. While more clinical evidence is needed to strongly support dry needling’s effectiveness for trigger points, the therapy is a generally safe procedure for most people. However, you should first talk to your primary doctor about whether dry needling is an appropriate therapy for your low back pain. He or she will help you understand any concerns as they relate to your current health state and medical history. Getting your doctor’s approval first will ensure your low back and overall health is protected.

Updated on: 11/09/18
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Spine Doctor's Treatment for Moderate Low Back Pain

Doctor Gerard Malanga gives an inside look at his care philosophy of a patient with moderate low back pain.
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