Muscle Energy Technique Versus Dry Needling of Active Trigger Points in Quadratus Lumborum: A Comparative Study on Functional Disability in Low Back Pain
Article Sidebar
Main Article Content
Abstract
Background: Lower back pain (LBP) is a prevalent condition that significantly impacts the quality of life and mobility of individuals. Active trigger points in the quadratus lumborum muscle are a common source of LBP, often requiring effective physiotherapeutic interventions. Dry needling (DN) and Muscle Energy Techniques (METs) are two commonly used treatments, though their comparative efficacy has not been extensively studied.
Objective: The study aimed to compare the effects of DN and METs on the functional disability of patients with active quadratus lumborum trigger points contributing to lower back pain.
Methods: In this randomized controlled trial, 24 patients were equally divided into two groups to receive either DN or METs over a three-week period, with sessions conducted twice weekly. The Modified Oswestry Disability Index (MODI) was employed to measure functional disability at baseline, after the first, third, and sixth sessions. Repeated measures ANOVA was utilized for intra-group and inter-group comparisons.
Results: Both interventions showed a decrease in MODI scores, indicating an improvement in functional disability. However, DN was significantly more effective than METs in reducing disability scores (p < 0.05). Notably, no significant difference was found between the post-treatment NPRS and PPT scores within or between the groups.
Conclusion: DN appears to be a more effective intervention than METs for reducing functional disability associated with active trigger points in the quadratus lumborum among LBP patients. Despite the efficacy of both treatments, DN may be prioritized as a preferred modality in clinical settings.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Popescu A, Lee H. Neck pain and lower back pain. Medical Clinics. 2020;104(2):279-92.
Tawrej P, Kaur R, Ghodey S. Immediate Effect of Muscle Energy Technique on Quadratus Lumborum Muscle in Patients with Non-Specific Low Back Pain. Indian Journal of Physiotherapy & Occupational Therapy. 2020;14(1).
Pourahmadi M, reza Ayoubpour M, Firouze B. The effect of dry needling compared to lumbar spine mobilization on functional disability, pain, quadratus lumborum and lumbar multifidus function, lumbar range of motion and pain pressure threshold in patients with non-specific chronic low back pain: Study protocol for a randomized controlled trial. 2023.
Timgren J. The Role of Myofascial Trigger Points in the Treatment of Reversible Functional Scoliosis. Int J Phys Med Rehabil. 2020;8(571):2161-0983.20.
Simon M, Pérez Bellmunt A, Peillon O, Ragazzi P, Myers Escolà A, López-de-Celis C. Treatment of the myofascial trigger-points of triceps surae: a systematic review. International Journal of Sports and Exercise Medicine. 2019.
Mirzaie H, Pourahmadi MR, reza Ayoubpour M. The effect of dry needling compared to lumbar spine mobilization on pain, functional disability, quadratus lumborum and lumbar multifidus function, lumbar range of motion and pain pressure threshold in patients with non-specific chronic low back pain: Study protocol for a randomized controlled trial. 2022.
Kumar S, Khuba S, Gautam S, Agarwal A, Vittobaraju M, Aggarwal A, et al. Association of Myofascial Pain in Patients with Thoracolumbar Scoliosis, Kyphoscoliosis or Spinal Deformity Attending a Tertiary Care Hospital in Uttar Pradesh, India. 2021.
Pérez-Bellmunt A, López-de-Celis C, Rodríguez-Sanz J, Hidalgo-García C, Donnelly JM, Cedeño-Bermúdez SA, et al. Dorsal dry needling to the pronator quadratus muscle is a safe and valid technique: A cadaveric study. Physiotherapy Theory and Practice. 2023;39(5):1033-7.
Balocco AL, López AM, Kesteloot C, Horn J-L, Brichant J-F, Vandepitte C, et al. Quadratus lumborum block: an imaging study of three approaches. Regional Anesthesia & Pain Medicine. 2021;46(1):35-40.
Sánchez-Infante J, Navarro-Santana MJ, Bravo-Sanchez A, Jimenez-Diaz F, Abian-Vicen J. Is dry needling applied by physical therapists effective for pain in musculoskeletal conditions? A systematic review and meta-analysis. Physical Therapy. 2021;101(3):pzab070.
Lara-Palomo IC, Gil-Martínez E, Antequera-Soler E, Castro-Sánchez AM, Fernández-Sánchez M, García-López H. Electrical dry needling versus conventional physiotherapy in the treatment of active and latent myofascial trigger points in patients with nonspecific chronic low back pain. Trials. 2022;23(1):238.
Volpe ET. Intrauterine Devices, Pelvic Pain, and Physical Therapy: A Case Report. Journal of Women's Health Physical Therapy. 2022;46(4):183-9.
Einstein A, Renee MJ, Salvo SG. Clinical Massage: Pain. Massage Therapy E-Book: Massage Therapy E-Book. 2022:284.
Ahmed K, Shaukat A, Noor R, Khalid S. Longitudinal Effects of Myofascial Release with and Without 8-Week Corrective Exercises in Correcting Upper Cross Syndrome. Annals of Medical and Health Sciences Research| Volume. 2022;12(5).
Luan S, Zhu Z-m, Ruan J-l, Lin C-n, Ke S-j, Xin W-j, et al. Randomized trial on comparison of the efficacy of extracorporeal shock wave therapy and dry needling in myofascial trigger points. American journal of physical medicine & rehabilitation. 2019;98(8):677-84.
Aksu Ö, Doğan YP, Çağlar NS, Şener BM. Comparison of the efficacy of dry needling and trigger point injections with exercise in temporomandibular myofascial pain treatment. Turkish journal of physical medicine and rehabilitation. 2019;65(3):228.
Gianola S, Bargeri S, Del Castillo G, Corbetta D, Turolla A, Andreano A, et al. Effectiveness of treatments for acute and subacute mechanical non-specific low back pain: a systematic review with network meta-analysis. British journal of sports medicine. 2022;56(1):41-50.
Prasetyo YF, Bajamal AH, Basuki H. Effect of pre-surgical factors against degenerative lumbal patient surgical actions: evaluation using modified oswestry disability index and rolland morris. Indonesian Journal of Neurosurgery. 2021;4(1):17-24.
Lew J, Kim J, Nair P. Comparison of dry needling and trigger point manual therapy in patients with neck and upper back myofascial pain syndrome: A systematic review and meta-analysis. Journal of Manual & Manipulative Therapy. 2021;29(3):136-46.
Fernández-De-Las-Peñas C, Plaza-Manzano G, Sanchez-Infante J, Gómez-Chiguano GF, Cleland JA, Arias-Buria JL, et al. Is dry needling effective when combined with other therapies for myofascial trigger points associated with neck pain symptoms? A systematic review and meta-analysis. Pain Research and Management. 2021;2021.
Mahmood T, Hafeez M, Ghauri MW, Salam A. Instrument assisted soft tissue mobilization-an emerging trend for soft tissue dysfunction. J Pak Med Assoc. 2021;71(3):977-81.
Ozdemir K, Keser I, Sen I, Ozgur Tan M. Investigating the relationships between quality of life, fatigue and leisure time physical activity in prostate cancer patients. Journal of Back and Musculoskeletal Rehabilitation. 2019;32(3):497-503.
Hamdy HA, Grase MO, El-hafez HM. Instrument Assisted Soft Tissue Mobilization versus Integrated Neuromuscular Inhibition Technique in Nonspecific Chronic Neck Pain: Single-blinding Randomized Trial. Journal of Chiropractic Medicine. 2023.
Aggarwal S, Bansal G. Efficacy of integrated neuromuscular inhibition technique in improving cervical function by reducing the trigger points on upper trapezius muscle: A randomized controlled trial. Muller Journal of Medical Sciences and Research. 2018;9(1):1-.
Greenberg JA, Zwiep TM, Sadek J, Malcolm JC, Mullen KA, McIsaac DI, et al. Clinical practice guideline: evidence, recommendations and algorithm for the preoperative optimization of anemia, hyperglycemia and smoking. Canadian Journal of Surgery. 2021;64(5):E491.
Sadeghnia M, Shadmehr A, Mir SM, Rasanani M-RH, Jalaei S, Salehi S. Comparison of Immediate Effect of High-Power Pain Threshold Ultrasound and Deep Transverse Friction Massage on Active Myofascial Trigger Points. Journal of Modern Rehabilitation. 2023.
Holz K. Chiropractic Manipulation and Shockwave Therapy versus Chiropractic Manipulation and Myofascial Dry Needling on Mechanical Low Back Pain with Associated Active Quadratus Lumborum Trigger Points: University of Johannesburg (South Africa); 2019.
Nayak PP. A Study to Find Out the Efficacy of Init (Integrated Neuromuscular Inhibition Technique) with Therapeutic Ultrasound Vs Init with Placebo Ultrasound in the Treatment of Acute Myofascial Trigger Point in Upper Trapezius: Rajiv Gandhi University of Health Sciences (India); 2013.