None listed
Conditions
Brief summary
The presence of the vasomotor reaction in the area where trigger points refer pain was presented. Short-term vasodilation after dry needling under IRT control of active TrPs was recorded but available data have some methodological weaknesses (e.g. the lack of randomization and control group) The aim of this study is to evaluate the response to dry needling under IRT control of low back pain radiating down patients compared to control group regarding TrPs presence.
Interventions
Forty chronic low back pain radiating down patients (experimental group) will be recruited to the study from Poznan GP doctors and the University Pain Clinic. Thirty healthy volunteers will be recruited by press announcement.
Experimental group will be examined towards TrPs presence within the gluteus minimus. After that subjects will be assigned to four groups; group I: TrPs-positive experimental (n=20), group II: TrPs-negative experimental (n=20), group III: TrPs-negative control (n=15), and
Forty chronic low back pain radiating down patients (experimental group) will be recruited to the study from Poznan GP doctors and the University Pain Clinic. Thirty healthy volunteers will be recruited by press announcement. Experimental group will be examined towards TrPs presence within the gluteus minimus. After that subjects will be assigned to four groups; group I: TrPs-positive experimental (n=20), group II: TrPs-negative experimental (n=20), group III: TrPs-negative control (n=15), and group IV: TrPs-positive control (n=15). Each of the participants will draw his/her pain on a diagram and define the pain on the visual analogue scale (VAS). Before the Infrared Thermovision camera (IRT) session, the presence of active TrPs for experimental and control within the gluteus minimus muscle will be re-examined. After that IRT side-to-side comparison of the lower limb will be performed and then all participants will receive the dry needling (DN) session (2x 5 minutes with the 30 second break) and post-dry needling observation at rest (six consecutive minutes) under IRT control. DN will be performed within the gluteus minimus muscle into: two TrPs (group I and group IV) or two the most tender points (group II and group III). The area to be observed by IRT will be chosen according to the gluteus minimus referred pain pattern. Additionally, during DN participants will be asked to report the area of referred pain (thigh, calf, foot). The participants and IRT camera operator will not be aware of the myofascial pain diagnosis results. During IRT, the dry needling specialist will not be aware of the IRT camera results. The dry needling under IRT control will be conducted once. Diagnostic criteria of active TrPs for experimental group: active TrPs will be confirmed if referred pain typical of the gluteus minimus muscle (anterior/posterior fibers) will be evoked digitally and by needle from tender points within that muscle and the patients will recognize that referred pain as their daily complaint. If a patient of the experimental is needle-positive only but he/she does not recognize referred pain evoked by the needle as familiar, the presence of active TrPs will also be confirmed but with the note “likely TrPs” as additional description. For healthy volunteers (control), only latent TrPs are possible to be present. Diagnostic criteria for the control group: latent TrPs within the gluteus minimus muscle will be confirmed if digital pressure of the most tender point within that muscle provokes referred pain typical of gluteus minimus muscle TrPs. Similarly to the experimental group, when only the needle-evoked referred pain occurs –likely TrPs (latent form) will be confirmed.
Sponsors
Poznan University of Medical Sciences
Study design
Allocation
Non-randomised trial
Intervention model
Parallel
Primary purpose
Diagnosis
Masking
Blinded (masking used) (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
20 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
Experimental group Key inclusion criteria: low back pain radiating down, age between 20 and 60 (inclusive), both lower limbs present, pain duration >3 months, >3 on the 1-10 point VAS scale;leg pain, with this being the dominant pain problem. Healthy volunteers Key inclusion criteria: general good health condition, age between 20 and 60 (inclusive), both lower limbs present
Exclusion criteria
Experimental group Key exclusion criteria: complex regional pain syndrome, cauda equina syndrome, previous back surgery, spinal tumors, scoliosis, pregnancy, coagulant treatment, disseminated intravascular coagulation, diabetes, epilepsy, infection, inflammatory rheumatologic diseases, stroke, or oncological history. Healthy volunteers Key exclusion criteria: previous back surgery, spinal tumors, scoliosis, pregnancy.
Outcome results
None listed