Dry Needling of Muscle Motor Points for Chronic Low-back Pain: A Randomized Clinical Trial With Long-term Follow-up

Fifty-six male patients who had chronic low-back pain of at least 12 weeks' duration (average duration, 28.6 weeks) and who had failed to respond to traditional medical or surgical therapy were entered into a randomized clinical trial to compare the relative efficacies of the Clinic's standard therapy regimen with and without dry needling at muscle motor points. Before entering the trial, all patients had undergone without improvement eight weeks of the Clinic's standard therapy regimen of physiotherapy, remedial exercises, and occupational therapy. The 29 study subjects and 27 control patients then continued with this regimen, but the study subjects also received needling at muscle motor points once or twice a week (average number of treatments, 7.9). All patients were assessed at the time of discharge, 12 weeks after discharge, and at the time of writing (average, 27.3 weeks). The group that had been treated with needling was found to be clearly and significantly better than the control group (P > 0.005, N = 53) with regard to status at discharge, status at 12 weeks' follow-up, and status at final follow-up. At final followup, 18 of the 29 study subjects had returned to their original or equivalent jobs and 10 had returned to lighter employment. In the control group, only four had returned to their original work and 14 to lighter employment; nine were still disabled. The results seem to justify the procedure in chronic low-back patients in whom myofascial pain (the majority) rather than skeletal irritation is the dominant disabling feature.