None listed
Conditions
Brief summary
The purpose of the study is to demonstrate that the treatment of the gluteus medius reduces nonspecific mechanical low back pain, specially if dry needling and an exercise program are performed instead of just exercise. We hypothesize that the weakness and the presence of trigger points is relationed directly with the low back pain of the patient, so the treatment focused on this muscle should reduce the low back pain level and also the disability. Two randomized groups, of at least 18 patients with low back pain per group, will participate in the study. In the first session, the intervention group will be performed dry needling in gluteus medium, while the control group will be performed placebo dry needling. Both groups will learn an exercise program focused on gluteus medium which must perform for 8 weeks (2 days per week). Outcomes have in count will be level of pain and disability, measured before the first session, after finishing the first session, and 1, 3 and 6 months after the first session.
Interventions
In the first session, in addition of all we´ve explained, the physiotherapy group will valorate the patients according to their kind of low back pattern. In next lines, we will explain the main characteristics of each kind of patron:
- Flexion:
-Pain during flexion-rotation activities, sedestation (like driving), and in semiflexion and complete flexion activities.
-In standing position: loss of low lumbar lordosis, muscular tone of high lumbar back and low dorsal back raised, "flatted
In the first session, in addition of all we´ve explained, the physiotherapy group will valorate the patients according to their kind of low back pattern. In next lines, we will explain the main characteristics of each kind of patron: - Flexion: -Pain during flexion-rotation activities, sedestation (like driving), and in semiflexion and complete flexion activities. -In standing position: loss of low lumbar lordosis, muscular tone of high lumbar back and low dorsal back raised, "flatted ass", high lumbar lordosis, central surcus and prominence of spinal erectors and hip in extenction and external rotation. -Flexion-relajation phenomenon: patients flex their back and then the erector relaxes -Sedestation with no pain except when patients make brusquely rotation. -During prolonged sedestation there is an increase in flexion of low back and pelvis retroversion -During low back flexion, patients use just 1/2 of the movement of the hip and appearance of great low back kyphosis. They don´t reach the floor with their fingers. -Active extenction -Central pain due to prolonged low back extenction and positions of extenction and rotation -Pain get worst with different activities: running, jumping, swimming and activities that require upper limbs above head -In standing position: pelvis posterior to thorax, great low lumbar lordosis with central surcus, very curved ass, muscular tone of low back raised, pelvis anteversion (posterosuperior iliac spine above anterosuperior iliac spine) and loss of high lumbar lordosis -Psoas and spinal erector very active -Low protruding abdomen -Hip flexors developed (anterior quadriceps rectum, iliac, tensor fasciae latae…) which generates anterior convexity in the thigh. -Presence of dimples on sacrum skin -Inability to maintain semiflexion posture (patients support this by putting their hands on their knees) -Pasive extenction -Pain for loss of motor control in extenction -Passive tendency to extend low back -Presence of pain in extenction position and during movement or activities in extenction position. Joint pain in activities prolonged in time -In standing position: Thorax posterior to pelvis, pelvis in retroversión, presence of kyphosis in high lumbar back, collapsed posture. -Low muscle tone -Little hip control
Sponsors
Daniel Pecos Martin
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
- Nonspecific low back mechanical pain - Adults between 18 and 65 years old. - Presence of nonspecific low back mechanical pain in the last year
Exclusion criteria
- Patients who underwent surgery in the lumbopelvic or hip región - Patients who are following a physiotherapist treatment to solve their low back pain. - Diabetic patients - Pregnant patients - Anticoagulated patients - Patients with belenofobia
Outcome results
None listed