Clinical Question

Is dry needling an effective treatment for chronic low back pain?

Evidence-Based Answer

A comprehensive treatment program that includes dry needling may provide some benefit in decreasing pain scores and perceived disability vs. standard physical therapy (PT) and home PT in the short term. However, this improvement is small, and the clinical significance is questionable. (Strength of Recommendation: B, randomized controlled trials [RCTs].) Additional research is needed to determine the best regimens to augment dry needling.

Evidence Summary

A 2016 single-blind RCT of adult patients (n = 58) with discogenic radicular back pain examined the effectiveness of dry needling plus PT vs. standard PT, which included transcutaneous electrical nerve stimulation (TENS), thermal modalities, and ultrasonography.¹ All patients received 10 sessions of PT every other day. At the end of PT sessions on even-numbered days, the dry needling group had 3- to 6-cm traditional acupuncture needles inserted into a trigger point or taut band; the needles were left in place until there was no more pain or twitching. Pain and disability were assessed using a visual analog scale (VAS; scored from 0 to 100) and the Oswestry Disability Index (scored from 1 to 50, with higher scores reflecting more notable disability) at the end of the session and two months later. There were no differences between the groups using dry needling plus PT vs. PT alone in baseline pain intensity on the VAS (79.0 vs. 74.1; P = .12) or Oswestry Disability Index (40.1 vs. 40.1; P = .93). The dry needling plus PT group had statistically lower postintervention VAS scores vs. PT alone (45.5 vs. 37.2; P = .04) and improved Oswestry Disability Index scores (32.7 vs. 28.5; P = .03), which persisted at the two-month follow-up (VAS = 42.4 vs. 25.2; P = .008; Oswestry Disability Index = 30.3 vs. 22.2; P = .003). This study was limited by the short follow-up period.