Comparison of Dry Needling and Sustained Pressure in Para-spinal Muscles Trigger Points
Condition: Low Back Pain
MeSH terms: Low Back Pain
Study type: Interventional

Summary: 
      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 .
    

Detailed description: 
      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
    

Intervention name(s): Dry Needling; Sustain Pressure
Intervention type(s): Other; Other
Intervention description(s): stretching exercises :single knee to chest (15 reps x 3 sets) double knee to chest(15 reps x 3 sets) strengthening exercises: extension exercises (15 reps x 3 sets); Sustain Pressure (Number of repetition and hold according to trigger point chronic level)
+ Hot pack 10 to 15 minutes + Active muscle stretching exercise (10 repetition twice daily)
Intervention MeSH terms: Sulfamethazine
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Dry Needling; Oswestry disability index,; Paraspinal muscle length; Pain pressure threshold