Low Back Pain Clinical Trial
Official title:
Comparison of Dry Needling and Sustained Pressure in Trigger Points of Lumbar Paraspinal Muscles
This study will compare the effect of dry needling and sustained pressure in the lumbar
Paraspinal trigger points in terms of pain threshold and muscle length.
There will be two groups ; experimental and control. Half of study group will receive dry
needling session along with stretching and strengthening exercises and half of study group
will receive sustained pressure technique along with stretching and strengthening exercises .
The study is Randomized Control Trail , which is being conducted in Pakistan Railway hospital
and Riphah international hospital (march 2019-june 2019) . Sample size of 50 individual was
calculated using epitool with 95% confidence interval (CI), and power 80%. 50 individual are
screened out according to inclusion criteria. Individuals are allocated randomly into two
groups , 25 in experimental group and 25 in control group by sealed envelope method.Both
groups will receive conventional physiotherapy protocol (hot pack, stretching exercises and
strengthening exercises) and then experimental group will receive cervical sensorimotor
control training. Assessment will be done on baseline, 2nd week, 4th week and 6th week.
Myofascial trigger point (MTrP) is moreover removed or inactivate by means of mechanical
stimuli through filiform needle. A swift and repetitious needle insertions into myofascial
trigger point is a treatment technique use for dry needling commonly has many therapeutic
advantages. It interrupts motor end plates, muscle fibers and distal axons of myofascial
trigger points and shortening of related sarcomere of myocytes.
Use of dry needling in combination Muscle Energy Technique (MET) has more significant effects
in improving Visual Analog Scale (VAS), Pain Pressure Threshold (PPT) and Range of Motion
(ROM) of females patients having latent trigger points in upper trapezius than alone use of
MET.
Laser therapy has verified as to be more successful than dry needling in treating MTrPs. It
is a preferred option for the patients having apprehensive behavior towards dry needling and
health practioners inexpert with the dry needling procedure.
Dry needling is indicated for the treatment when MTrPs are present, may leads to functional
restrictions. They are the source of constant peripheral nociceptive contribution which needs
to be inactivated. Dry Needling (DN) is also indicated in fascial adhesions, soft tissue
restrictions, shortened muscle fiber due to which restricted range of motion is
present.Secondary trigger point (TrP) due to different neuromuscular dysfunctions for example
in tendonitis, radiculopathies, disk pathology, migraines, carpal tunnel syndrome, tension
type headache, joint dysfunction, cranio-mandibular dysfunction, phantom pain , additional
regional urological syndromes and other exceptional neurogenic pruritus, Barre Lieou syndrome
;
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