Low back pain (LBP) is defined as pain below the scapulae and above the buttocks with or without radiation into the extremities. LBP is a common occurrence in approximately eighty percent of the population at some point in life. In the United States, LBP is the second leading cause for medical consultation and fifty billion dollars are spent annually for its’ medical coverage.
The Treatment Based Classification system is the standard of care for physical therapy treatment of LBP. It consists of subgrouping patients based on signs, symptoms, acuity and physical findings into 1 of 4 groups: direction preference, manipulation, stabilization, or traction as indicated.
The insertion of dry needles into connective tissue and neurovascular bundles has been proven to be effective in relieving pain and disability in a variety of conditions including LBP. There are different theories explaining how this works including Melzack’s gait theory that proposes that the insertion of needles causes increased input to the central mechanism and thus causes the gait to pain to close. Hong later proposed that dry needling into trigger points with a local twitch response causes a break in the pain cycle.