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The effectiveness of dry needling of the Gluteus Medius muscle in combination with active exercises will be examined compared with sham needling with active exercises in low back pain (LBP) patients.
Objectives: To examine if dry needling in combination with active physiotherapy is more effective in reducing pain and increase activity of daily living, range of motion and muscle strength in patients with chronic low back pain compared to sham dry needling in combination with active physiotherapy.
Methods: the study will include individuals with non-specific LBP over 3 months.
Subjects will be divided randomly into two research groups, both will receive physiotherapy including mobility, strengthening and stretching exercises. Intervention group, additionally to exercises, will receive dry needling to the Gluteus Medius muscle by inserting a needle to a trigger point until a visible involuntary twitch in the muscle appears. Sham needling will be applied by needling with pre-cut and smoothed needles that will not penetrate the skin.
Both groups will receive two treatments per week and up to six treatments overall, evaluation will be performed before and after the series of treatments.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| research group | Experimental | active exercises and dry needling for the Gluteus medius muscle |
|
| control group | Sham Comparator | active exercises and sham dry needling for the Gluteus medius muscle |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| dry needling | Other | dry needling for Gluteus Medius muscle in combination with exercises |
| |
| Measure | Description | Time Frame |
|---|---|---|
| change in visual analog scale (VAS) | assessing pain on a scale from 0 (no pain) to 10 (most sever pain). Higher scores means worse outcome. | baseline and at 3 weeks |
| Change in Modified Oswestry Disability Index | questionnaire to assess the disability level associated with LBP and includes 10 questions regarding activities likely to be affected by LBP. Higher scores means worse outcome. | baseline and at 3 weeks |
| Global rating of change | a 15-point Likert scale ranging to assess treatment success. Higher scores mean a better outcome. | 3 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Change in hip abductors muscle strength | muscle strength in Newton, assessed by an hand held dynamometer | baseline and 3 weeks |
| Change in lumbar flexion range of motion | lumbar flexion assessment by bending forward and measuring distance of fingers from the floor |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Gali Dar, PhD | Gali Dar, Department of Physical Therapy, University of Haifa | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Haifa University, Department of PHysical Therapy | Haifa | 31905 | Israel |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26006705 | Result | Cooper NA, Scavo KM, Strickland KJ, Tipayamongkol N, Nicholson JD, Bewyer DC, Sluka KA. Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls. Eur Spine J. 2016 Apr;25(4):1258-65. doi: 10.1007/s00586-015-4027-6. Epub 2015 May 26. | |
| 26406203 | Result | Dar G, Hicks GE. The immediate effect of dry needling on multifidus muscles' function in healthy individuals. J Back Musculoskelet Rehabil. 2016 Apr 27;29(2):273-278. doi: 10.3233/BMR-150624. |
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following study completion, a paper will be submitted to international professional journal
6 months following end of study
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| ID | Term |
|---|---|
| D017116 | Low Back Pain |
| ID | Term |
|---|---|
| D001416 | Back Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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| ID | Term |
|---|---|
| D000079245 | Dry Needling |
| ID | Term |
|---|---|
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
| D026741 | Physical Therapy Modalities |
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two groups. research group will receive dry needling and control group will receive sham dry needling.
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participants will not be aware of the group they were assigned
| sham dry needling |
| Other |
sham dry needling for Gluteus Medius muscle in combination with exercises |
|
| baseline and 3 weeks |
| 39954045 | Derived | Dar G, Goldberg A. Dry needling of the gluteus-medius muscle, combined with standard care, for chronic low back pain - a pilot randomized sham-controlled trial. J Man Manip Ther. 2025 Oct;33(5):392-400. doi: 10.1080/10669817.2025.2465726. Epub 2025 Feb 15. |
| D013568 |
| Pathological Conditions, Signs and Symptoms |