Efficacy of Dry Needling and Intramuscular Dry Needling Stimulation on Quadratus Lumborum in Patients with Mechanical Low Back Pain

Gerald Edwin Raj; Vinodhkumar Ramalingam; M. K. Franklin Shaju

doi:10.15391/prrht.2025-10(2).08

Authors

Gerald Edwin Raj RVS College of Physiotherapy, Coimbatore, India https://orcid.org/0000-0002-6520-347X
Vinodhkumar Ramalingam Saveetha college of physiotherapy, Saveetha Institute of Medical and Technical Science, Chennai, India https://orcid.org/0000-0002-5269-0520
M. K. Franklin Shaju RVS College of Physiotherapy, Coimbatore, India https://orcid.org/0009-0003-0054-7284

DOI:

https://doi.org/10.15391/prrht.2025-10(2).08

Keywords:

Mechanical low back pain, Pressure Algometer, Oswestry Disability Index (ODI), Sway meter, Intramuscular Dry Needling Stimulation (IMDNS), Dry Needling (DN), Randomized control trail

Abstract

Low back pain (LBP) is characterized by pain or discomfort in the lower back, often accompanied by decreased in lateral flexion range of motion. The average lifetime incidence of LBP is as high as 84%, with approximately 23% of individuals experiencing chronic pain.

Purpose. This study aimed to compare the efficacy of Quadratus Lumborum Intramuscular Dry Needling Stimulation (IMDNS) and standard Dry Needling (DN) in managing pain, postural sway, and disability in patients with mechanical low back pain.

Material & Methods. A randomized controlled trial was conducted with 51 participants aged 30 to 45 with mechanical low back pain and Quadratus Lumborum pain who met the study's inclusion criteria. Participants were randomly assigned in a 1:1:1 ratio to three groups and received three sessions per week for three weeks. Group A received Intramuscular Dry Needling Stimulation (IMDNS), Group B received Dry Needling (DN), and Group C underwent conventional physiotherapy with Interferential Therapy (IFT). Additionally, all three groups received Quadratus Lumborum stretching. Outcome measures included pain threshold (assessed with a pressure algometer), postural sway (measured using a sway meter), and functional disability (evaluated using the Oswestry Disability Index, ODI). Assessments were conducted at baseline (pre-intervention) and follow-up (post-intervention). Statistical significance was set at p<0.05. The data was analyzed using One-Way ANOVA and Tukey's Post Hoc test.

Results. The study found significant differences in postural sway, disability, and pain threshold among back pain patients. The mean value, standard deviations and p value for postural sway among Group A (2.59, 0.68 & 0.00), Group B (1.86, 1.04& 0.00) & Group C (1.39, 0.81 & 0.00). The mean value, standard deviations and p value for Disability among Group A (13.7, 3.99 & 0.00), Group B (12.94, 4.04 & 0.00) & Group C (9.65, 5.11 & 0.00). The mean value, standard deviations and p value for Pressure threshold among Group A (1.50, 0.422 & 0.00), Group B (1.14, 0.37 & 0.00) & Group C (0.89, 0.48 & 0.00). When comparing all groups for postural sway the calculated 'F’ & p’ value is 8.43 & 0.001. When comparing all groups for disability the calculated 'F’ & p’ value is 4.062 & 0.00. When comparing all groups for pressure threshold the calculated 'F’ & p’ value is 8.43 & 0.001. The calculated p value for all three groups is less than the common alpha level (0.005), hence there is significant difference between postural sway, disability and pressure threshold.

Conclusions. These findings indicate that IMDNS found to be more effective than DN and conventional physiotherapy in reducing postural sway, disability, and pain threshold in patients in patients with mechanical low back pain.

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