Clinical trial NCT06756776: Dry Needling vs. Stretching for Non-Specific Low Back Pain
Official title: Effects of Dry Needling Versus Stretching of Hamstrings Muscles With Lumber Sustained Natural Apophyseal Glides on Pain, Range of Motion, Muscle Length and Disability in Patients With Non-specific Low Back Pain
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Non Specific Low Back Pain
Keywords: non-specific low back pain
dry needling
SNAGs
ROM
disability
muscle length
Lead sponsor: Riphah International University
Sponsor class: OTHER
First posted: 2025-01-03
Enrollment: 44
Sex: ALL
Minimum age (years): 20
Maximum age (years): 40
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Chronic low back pain (CLBP) is one of the common health issues and a leading cause of reduced mobility. It is characterized by pain during functional activities and is often associated with hamstring tightness. CLBP affects individuals across all age groups. Various methods are used to address low back pain, including manual therapy. Manual therapy techniques include Maitland mobilizations, Kaltenborn mobilizations, Mulligan techniques, stretching, and others.

Several stretching techniques have been proposed, including static stretching, dynamic stretching, ballistic stretching, and proprioceptive neuromuscular facilitation (PNF). Among these, static and dynamic stretching are the most commonly used methods. Static stretching is considered one of the safest and easiest techniques, which can be performed passively or actively. Literature supports that stretching improves muscle flexibility, provides relaxation, reduces pain, and increases the range of motion (ROM).

Dry needling is another physical intervention technique that has been utilized for patients with musculoskeletal disorders. Current literature supports the use of dry needling for trigger points in hamstring muscles, which is a contributing factor to low back pain.

The objective of this study is to compare the effects of dry needling and stretching combined with sustained natural apophyseal glides (SNAGs) on pain, ROM, muscle length, and disability in patients with non-specific low back pain.

A randomized clinical trial will be conducted at Hijaz Hospital using convenience sampling to recruit participants. Patients will be allocated into two groups (Group A and Group B) through simple random sampling using sealed opaque envelopes. After conventional treatment, Group A will receive SNAGs and stretching, while Group B will receive SNAGs and dry needling.

Outcome measures will include the goniometer for ROM, the Modified Oswestry Disability Index (MODI) for disability, the Numeric Pain Rating Scale (NPRS) for pain, and the Finger-to-Floor Distance Test for hamstring flexibility. These measures will be assessed at baseline, at the 2nd week, and after 4 weeks. Data will be analyzed using SPSS software (version 21).

The normality of the data will be assessed using the Shapiro-Wilk test. Based on the results, parametric or non-parametric tests will be used for within-group and between-group comparisons. SNAGs and dry needling will be evaluated for their effectiveness in treating non-specific low back pain.


Eligibility criteria: Inclusion Criteria:

* minimum 3 months chronicity of low back pain
* with tight hamstrings and positive passive knee extension test (12)

Exclusion Criteria:

* Chronic systemic bony and soft tissue diseases
* Recent history of trauma
* Degenerative joint diseases
* Psychiatrist diseases

Primary outcomes:
measure: Numeric Pain Rating Scale (NPRS)
timeFrame: baseline, 2 weeks, and 4 weeks
Secondary outcomes:
measure: Fingertip to Floor distance test
timeFrame: baseline, 2 weeks, and 4 weeks
measure: Passive knee extension test
timeFrame: baseline, 2 weeks, and 4 weeks
measure: Modified Oswestry Disability Index (ODI) (Urdu version)
timeFrame: baseline, 2 weeks, and 4 weeks
Other outcomes:
Locations:
city: Lahore
country: Pakistan
facility: Hijaz Hospital Lahore
state: Punjab
Study officials:
affiliation: Riphah International University
name: Danish Hassan, PhD*
role: PRINCIPAL_INVESTIGATOR
References: