Background and purpose: Physical therapy is a common treatment with multiple interventions for patients with chronic low-back pain. Chronic low-back pain is a common diagnosis with significant complexity in treatment. The purpose of this study is to research and discuss if dry needling enhances the efficacy of standard treatment for patients with chronic low-back pain. Case Description: The patient in this case is a 35 year-old female diagnosed with chronic low-back pain. She initially presented to physical therapy following a motor vehicle accident that resulted in neck, upper-back and lower-back pain. Her disability from neck and upper back pain resolved quickly. The low-back pain persisted through the course of treatment and progressed to chronic low-back pain including psychological factors and related disability. She was reevaluated following seven months of physical therapy without complete resolution of symptoms. Her most significant limitations at reevaluation include an inability to stand more than 15 minutes, pain with prolonged sitting over two hours, and an inability to return to previously enjoyed high-level activities including running. Outcomes: Nine articles were found through literature searches and critically evaluated. The literature demonstrated support for adding dry needling to a course of treatment including exercise, manual therapy and education. The patient appeared to have temporary improvements following the addition of dry needling to the course of treatment. These improvements did not persist, and the patient was referred for further imaging following five treatments that included individualized therapy including dry needling for the low-back pain. Discussion: High quality literature regarding dry needling for chronic low-back pain is lacking. The author utilized literature regarding acupuncture and dry needling, finding it to support the addition of trigger-point dry needling to standard care for a patient with chronic low back pain. The patient presented did not respond well to this treatment, and due to multiple factors, was referred for further imaging with a physician. Further studies to create guidelines for optimum dosing are needed.
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Acupuncture Therapy; Low Back Pain; Physical Therapy Modalities
Schmidt, Catherine. "Dry needling's efficacy in chronic low-back pain." (2016). http://digitalrepository.unm.edu/dpt/5