Dry Needling for Low Back Pain

(PINPOINT Trial)

Overseen By Ryan Pontiff, PT, DPT, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: The University of Texas Medical Branch, Galveston

Must not be taking: Anticoagulants

Disqualifiers: Lumbar surgeries, Radicular symptoms, Neurological conditions, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 11

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to evaluate the impact of dry needling on pain relief and quality of life for individuals with chronic low back pain. Participants will receive one of three treatments: dry needling alone, or dry needling combined with either high-rate or low-rate PENS (a form of electrical stimulation). The study seeks individuals who have experienced chronic low back pain for at least three months and feel it most days. Participants should not be undergoing other treatments for their back pain and must have intact sensory function.

As an unphased trial, this study offers a unique opportunity to contribute to understanding new treatment combinations for chronic low back pain.

Do I have to stop taking my current medications for the trial?

The trial information does not specify if you need to stop taking your current medications. However, if you are taking anticoagulants (blood thinners), you may be excluded from participating.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that dry needling is generally safe, and most people tolerate it well. A recent study provided strong evidence that it helps reduce pain. Many participants reported feeling less pain and stronger after treatment. However, some experienced mild side effects like soreness or bruising, which are common and usually resolve quickly.

For those considering dry needling with high-rate or low-rate PENS (a type of electrical stimulation), studies have shown it to be equally safe. Adding PENS did not significantly increase side effects. Most participants experienced positive outcomes, such as reduced pain and improved movement.

Overall, dry needling and its variations appear to be safe options for managing chronic low back pain, with only minor and temporary side effects reported. ^{1 2 3 4 5}

Why are researchers excited about this trial's treatments?

Researchers are excited about these treatments because they offer a new approach to managing low back pain. Unlike standard treatments like pain medications, physical therapy, or surgery, dry needling targets specific muscle trigger points to relieve pain and improve mobility directly. Additionally, the use of high-rate and low-rate PENS (Percutaneous Electrical Nerve Stimulation) alongside dry needling is an innovative combination that might enhance pain relief by stimulating nerve activity. These methods could provide faster and more effective relief with fewer side effects than traditional options.

What evidence suggests that this trial's treatments could be effective for low back pain?

Research has shown that dry needling can treat chronic low back pain by reducing pain and improving movement. Studies have found that dry needling reduces muscle stiffness and pain. In this trial, one group will receive only dry needling. Another group will receive dry needling combined with high-rate PENS (a type of electrical stimulation), which provides strong pain relief soon after treatment. A third group will receive dry needling combined with low-rate PENS, which also helps reduce pain and improve movement. Overall, dry needling and its combinations show promise for easing chronic low back pain. ^{2 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for individuals with chronic low back pain who are looking to improve their pain management and quality of life. Specific eligibility criteria details were not provided, so interested participants should contact the study organizers for more information.

Inclusion Criteria

I am between 18 and 65 years old.

I have had chronic low back pain for at least 3 months.

I haven't had back pain for more than a day in the last 3 months.

Exclusion Criteria

Individuals currently seeking any form of medical treatment for lumbar conditions beyond routine physician follow-up appointments

Participants with conditions affecting sensory processing

I do not have conditions like impaired sensitivity, blood thinners use, weak immune system, infections, cancer, removed lymph nodes, autoimmune disease, metal allergies, pregnancy, or osteoporosis.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Phase 1 Treatment

Participants undergo 3 dry needling sessions over 1 to 2 weeks

1-2 weeks

3 visits (in-person)

Phase 2 Treatment

Participants are block-randomized into intervention groups, complete baseline assessment, 6 intervention visits, and post-intervention assessments

2 months

8 visits (in-person)

Follow-up

Participants complete one- and three-month survey follow-ups

3 months

What Are the Treatments Tested in This Trial?

Interventions

• Dry Needling

Trial Overview The trial is testing three types of dry needling treatments: one using high-rate PENS (Percutaneous Electrical Nerve Stimulation), another with just dry needling, and a third using low-rate PENS. The goal is to see which method best reduces pain and enhances life quality.

How Is the Trial Designed?

Group I: Dry Needling Plus low-rate PENS Experimental Treatment 1 Intervention

This grouping will receive dry needling plus low-rate PENS. The group will receive the dry needling at visits 2-7.

Group II: Dry Needling Plus high-rate PENS Experimental Treatment 1 Intervention

This grouping will receive dry needling plus high-rate PENS. The group will receive the dry needling at visits 2-7.

Group III: Dry Needling Only Group Experimental Treatment 1 Intervention

This group will receive dry needling only. The group will receive the dry needling at visits 2-7.

Who Is Running the Clinical Trial?

The University of Texas Medical Branch, Galveston

Lead Sponsor

Trials

263

Recruited

55,400+

National Institute of Neurological Disorders and Stroke (NINDS)

Collaborator

Trials

1,403

Recruited

655,000+

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/36399082/

Efficacy of Dry Needling for Chronic Low Back Pain Results suggested that compared with other treatments, dry needling combined was more effective in alleviating the pain intensity of LBP post-intervention ( ...

2. nature.com nature.com/articles/s41598-022-19980-1

The effectiveness of dry needling in patients with chronic ... There were significant differences in pain reduction (VAS) in both groups (p < 0.001). The strongest analgesic effect in the DN group yielded ...

3. jpain.org jpain.org/article/S1526-5900(24)00425-5/fulltext

The Effect of Combining Spinal Manipulation and Dry ... Throughout the duration of the study, participants self-reported pain levels and LBP-related disability decreased in the 4-week treatment period ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9255226/

Effect of dry needling on lumbar muscle stiffness in patients ... Dry needling appears to reduce resting erector spinae muscle following treatment of patients with LBP. Therefore, providers should consider the use of dry ...

5. neurology.org neurology.org/doi/10.1212/WNL.0000000000204568

Treating Myofascial Pain with Dry Needling: A Systematic ... Conclusions: Dry needling is an effective procedure for the treatment of myofascial pain in patients with acute and chronic low back pain.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7015026/

ADVERSE EVENTS ASSOCIATED WITH THERAPEUTIC ... A recent meta-analysis demonstrates that moderate evidence exists to support dry needling as an effective intervention to reduce pain associated with ...

7. jospt.org jospt.org/doi/10.2519/jospt.2017.7096

The Effectiveness of Trigger Point Dry Needling for ... Studies provided evidence that dry needling may decrease pain and increase pressure pain threshold when compared to control/sham or other treatment.

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11419425/

Comparison of the effects of dry needling and spinal ... Comparison of the effects of dry needling and spinal manipulative therapy versus spinal manipulative therapy alone on functional disability and ...

9. clinicaltrials.gov clinicaltrials.gov/study/NCT05214456

The Effect of Dry Needling Compared to Lumbar Spine ... The main objective of this study is to compare the effects of dry needling and lumbar spinal mobilization on pain intensity, functional disability, lumbar ...