The Use of Trigger Point Dry Needling and Intramuscular Electrical Stimulation for a Subject with Chronic Low Back Pain: a Case Report

Overview

Journal Int J Sports Phys Ther

Specialty Rehabilitation Medicine

Date 2013 Apr 18

PMID 23593553

Citations 23

Authors

Charles E Rainey

Affiliations

Soon will be listed here.

Abstract

Study Design: Case Report.

Background And Purpose: Myofascial trigger points (MTrPs) are widely accepted by clinicians and researchers as a primary source of regional neuromusculoskeletal pain. Trigger point dry needling (TrP-DN) is an invasive procedure that involves stimulation of MTrPs using an monofilament needle. The purpose of this case report is to report the outcomes of TrP-DN and intramuscular electrical stimulation (IES) as a primary treatment intervention in a subject with chronic low back pain.

Case Description: The subject was a 30-year-old female, active duty military, who was referred to physical therapy for low back and right posterolateral hip pain. She noticed symptoms after suffering a lumbar flexion injury while picking up a barbell during weight training. Physical examination demonstrated findings that supported the diagnosis of lumbar segmental instability with a right hip stability dysfunction. Objective findings included a multi-segmental flexion movement pattern dysfunction and MTrPs in the right gluteus maximus and gluteus medius muscles with deep palpation. The subject was treated with TrP-DN and IES for a total of two visits. Bilateral L3 and L5 multifidus and right gluteus maximus and medius muscles were treated, along with implementing a home exercise program consisting of core stability exercises.

Outcomes: The subject reported no existing pain and disability on the Numerical Pain Rating Scale and Oswestry Disability Questionnaire and a large perceived change in recovery on the Global Rating of Change at final follow-up. Physical examination was normal, demonstrating no observed impairments or functional limitations, including normal multi-segmental flexion and no MTrPs with deep palpation.

Discussion: The subject was able to return to full military active duty without any physical limitations and resumed pre-injury activity levels, including the ability to resume all activities without pain. There is much promise regarding the use of TrP-DN with IES intervention for the treatment of lumbar and/or hip stability dysfunction. Future research is recommended to determine if TrP-DN intervention, with and without IES, is effective for other body regions and long-term subject outcomes.

Level Of Evidence: Level 4.

Citing Articles

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Electrical dry needling versus conventional physiotherapy in the treatment of active and latent myofascial trigger points in patients with nonspecific chronic low back pain.

Lara-Palomo I, Gil-Martinez E, Antequera-Soler E, Castro-Sanchez A, Fernandez-Sanchez M, Garcia-Lopez H Trials. 2022; 23(1):238.

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