Does Dry Needling Work for Low Back Pain?

Dry needling is a functional technique that is effective in eliminating low back pain. Often patients have sore, tight muscles with low back pain. Typically, muscle tightness is a response to a problem caused by a disc injury or arthritis. Even when these sources of pain have been addressed, the pain can persist because of the surrounding tight muscles forming trigger points. Pain caused by trigger points can slow recovery and limit patients’ ability to regain their previous function. Dry needling is a technique that can help address these painful trigger points in the muscles. Learn how to eliminate low back pain.

What are Trigger Points?

Trigger points are created by over-stimulated muscles. Typically, the injured structure in the lower back, such as a disc, sends a message to a stabilizing muscle to help protect it. The surrounding muscles activate to help protect the injured area. Those muscles end up working overtime and use up all their muscle fuel (ATP). The lack of muscle fuel causes the muscle to remain tightened because it takes additional energy for a muscle to relax after a contraction. The muscle not being able to relax starts to cause the formation of trigger points. Increased tightness blocks the blood flow, limiting the muscle to receive any new muscle fuel.

Trigger points have been found in studies, to have increased inflammation markers, cytokines, and chemokines. In addition, these trigger points have elevated amounts of neurotransmitters which cause increased pain sensitivity. Trigger points in the muscles of the low back can create significant pain in low back pain patients.

How Does Dry Needling Help?

Dry needling helps create a twitch reflex that allows the muscle to relax and regain its muscle function. The fuel/energy is replenished by the increased blood flow entering the trigger point. This allows the muscle to remain relaxed. The release of the trigger point also helps reduce the pain by allowing muscle cell waste/painful substances to move out of the tightened muscle. After the twitch reflex occurs, the muscle is extremely weak due to its inactivity. Generally, after needling, the therapist will provide exercises to begin to strengthen the muscles again. 

What Muscle to Needle?

A muscle that is most commonly needled in the low back is the multifidus. The multifidus muscle is a muscle that lies deep in the spine that helps bind the vertebrae together to stabilize them. Once the multifidus becomes over-stimulated, it becomes taut across two or more vertebrae. The multifidus muscle trigger points cause tightness and act as a vice between the vertebrae. The increased tension by the multifidus between the vertebrae puts compression pressure on the nerve between the vertebrae.

This pressure on the nerve can lead to nerve pain which can travel down the leg. The trigger point release, done with dry needling, can reduce the tension between two vertebral segments, helping to reduce compression around the nerve root. In addition, the nerve supply to the multifidus is the same as the joints in the lower back. The release allows the nerve not to be overly stimulated and helps reduce painful referral pain to the lower back joints.
Dry needling when done by a trained physical therapist is a safe and effective treatment for some types of low back pain. The reduction of pain and gain of function can be immense with dry needling. With the aid of other manual techniques, exercises, and modalities, dry needling can be a valuable tool to aid and speed your recovery. Freedom PT Services has highly trained and certified Dry Needling Specialists to help get you back on the road to recovery.

Wes Kokott
With specializing in advanced orthopedic techniques, Wes is uniquely equipped to help you get back to pain-free activity. He is also extremely passionate about treating baseball players.