Changes in lumbar multifidus muscle function and nociceptive sensitivity in low back pain patient
responders versus non-responders after dry needling treatment
This issue of the Physio Window follows up on a previous issue (2016) dedicated to dry needling which showed significant differences in muscle recruitment immediately post dry needling procedure of specific spinal segments, in healthy individuals.
The primary purpose of the current study was to examine changes in Lumbar Multifidus (LM) muscle function and nociceptive sensitivity after dry needling in patients with chronic LBP and to determine if such changes differ in patients that exhibit improved disability after dry needling treatment (responders) and those that do not (non-responders).
Outcome measures of this study were sampled at baseline, immediately following dry needling treatment to the LM muscles and after one week. The outcome measures were:
Ultrasound measurements of LM muscle thickness (at rest and contraction), Pain algometry of the LM, Pressure pain threshold (PPT) - used to measure nociceptive sensitivity, Oswestry Disability Index (ODI) – subjective measure
Responders were defined as participants who experienced clinical improvement greater than or equal to 30% change in ODI. Non responders ODI score was less than 30% change.
Results:
- 25 Patients (out of 66) classified as responders and experienced a 62.1% mean improvement in ODI scores
- Responders exhibited larger improvements in LM muscle contraction (muscle thickness change) of 26% after 1 week follow up
- Pressure pain threshold was 26.9% improved relative to baseline after 1 week.
Conclusions:
- Dry needling may facilitate lumbar multifidus contraction in patients with LBP.
- Dry needling may improve nociceptive sensitivity in patients with LBP.
- Responders to dry needling may exhibit different physiologic changes than non-responders.
The previous (2016) study demonstrated positive physiologic changes in muscle recruitment levels of healthy individuals. This study demonstrates positive physiologic changes and clinical outcomes in low back pain patient population, which 38% of the patients responded to.
Koppenhaver SL, Walker MJ, Su J, McGowen JM, Umlauf L, Harris KD, Ross MD. Changes in lumbar multifidus muscle function and nociceptive sensitivity in low back pain patient responders versus non-responders after dry needling treatment. Man Ther. 2015 Dec 20