Can Dry Needling Help My Lower Back Pain?
When you have an injury that is causing you pain that has lingered for months with no change, you start to wonder if it’s something serious. I had a similar problem where I thought I would need surgery or something more invasive like a cortisone injection. I was anxious and afraid of what may happen to my life. Luckily enough I stumbled upon dry needling which helped kickstart my rehabilitation journey to wellness. If you would like to read more on this you can click here.
One of the reasons why I am so passionate about helping people with back problems it that I had an injury myself that was hard to figure out. I tried all the stretches I knew from my physiotherapy schooling, looked online for advice and even sought care from other health professionals. But it wasn’t enough to help me find relief. I needed a reset so I could start over. I was constantly in pain with tingling down my leg and foot. It was frustrating not finding a solution.
Dry needling was one of the modalities that I came across during my search for relief. The particular type of dry needling was from the Gunn IMS Institute at the University of British Columbia. Dr. Gunn worked with many different worker’s compensation patients who were having persistent pain. With his knowledge as a doctor and his background in acupuncture, he developed a methodology to treat chronic persisting pain, known today as intramuscular stimulation or dry needling.
What is the theory behind it?
We have nerves that travel all around our body. The brain is where all this information is processed and it is sent and received from all the different parts of our body through an information highway known as the nervous system. The nervous system is a network of nerves which send information in the form of electrical signals throughout the body. These nerves originate from the spinal cord and exit at the spine to provide sensation to touch on our skin, strength in our muscles, and awareness of what our body is doing in space. Nerves can regulate different bodily responses and provide ways for the body to protect itself.
This image depicts nerves travelling from the spine throughout the body to the extremities.
When nerves are compressed, this results in a variety of symptoms:
Supersensitive muscles
Altered sensation of the skin
Increased nerve tension along certain limbs
Decreased body space awareness of the affected area
Pain in areas unrelated to the spine
Dry needling or intramuscular stimulation can help relieve compression of nerves by treating the muscles around the spine. By placing a thin filament-like needle into a tight band of muscle and removing it immediately, we can provide relief to an otherwise compressed nerve. This results in the reversal of the symptoms stated above.
What does a compressed nerve look like?
A more obvious example is tingling, burning, and numbness down the leg with back pain. But let’s use Xavier for example, whose case was not as straightforward and had a tight muscle for years.
Xavier would stretch, stretch, and stretch with no change in this feeling of tightness in the front of his thigh. For years he would use a foam roller and painfully push on trigger points in hopes to find relief. But to no avail, he could not change the symptoms he was experiencing. Xavier came to my clinic frustrated and confused. He mentioned that his massage therapist told him his quadricep was tight and that he had a bunch of trigger points that needed to be released. But no matter how many sessions he would attend, the tightness would return the next day. His tight muscle was now affecting his basketball game and he desperately wanted to return to shooting hoops. Xavier does not recall injuring himself recently and is frustrated. He heard about dry needling hoping it could release the tension of his thigh muscle.
Xavier’s story is very similar to a lot of my clients looking for relief for persistent muscular knots and tight muscles. The question is what do we do about it?
We looked at Xavier’s lower back first. We noticed that he could not bend his lower back far enough and he was limited in bending forward as well. Xavier is a student and spends most of his time sitting. He mentioned that he has had back pain, but it was on and off and didn’t think much of it. We assessed further and found that the front of his leg was very weak. When I asked Xavier to kick his leg straight in sitting, he could not resist the pressure of my hand. Xavier was confused because he would workout every day of the week and never skipped leg day. We had him lie on his stomach and his affected leg would not bend as far as the other. I quickly checked his back and found that there was increased muscular tension. We applied pressure to his back and found that it would produce a sensation on the front of his thigh.
Dry needling can help you find relief from low back pain.
People will often notice their back pain and choose to ignore it. We are not often aware of how limited we are in motion until it prevents us from doing something we love. Lying on your stomach and bending one knee is a nerve tension test. This allows us to check if nerves in the front of your leg are under tension. Your physiotherapist can perform other tests to find out if your leg symptoms are related to your back.
I explained the risks and benefits of dry needling and Xavier was happy to try anything that would give him relief. We applied several needles to the lower back and rechecked the prone knee bend test and leg strength. His leg strength was restored and Xavier could apply more pressure when kicking his leg against my hand. Xavier’s knee was able to bend further on his stomach. He also reported that his leg did not feel as tight anymore. He returned for several more sessions where we continued to treat his back and leg and in 4 weeks was back to playing basketball with minimal pain.
Most people will assume that their pain is related to the area they are feeling it in. However, there is a chance that the source could be somewhere else – this phenomenon is called pain referral. Think of an ice cream headache. Although a bite of cold ice cream touches your palate, it refers a painful sensation to your forehead known as an ice cream headache. Nerves are similar. They conduct signal from one location to another. When that signal is altered by compression, it can create strange sensations in a location seemingly unrelated to the spine. At Break Free Physiotherapy and Wellness in London, Ontario, our goal is to help you find the source of your pain and tightness. We look for patterns to help you find the relief that you need. Take it from someone who had tingling down the left side of his leg any time he would stand or sit for 5 minutes.
When I was treated with dry needling for my injury, it was obvious that my pain was coming from my lower back because of the sensations of tingling and numbness down my leg. My physiotherapist found the exact location in my spine that was causing the tingling and pain down my leg and applied a needle into the muscle to release tension and relieve compression of the nerve root. Instantly I regained strength I had lost for years and the pain in my back and leg had diminished. We completed about 8 sessions and I found that exercises that were painful before were now beginning to feel more normal. I could run again, albeit short distances. With the help of another physiotherapist who prescribed exercises, I was able to return to running and even completed my first half marathon.
The secret
The art of healing comes from understanding the injury and patterns followed by choosing the right treatment application in the exact location. By pairing this with compassion from your physiotherapist and dedication from you, healing can occur. We believe that the body has the amazing ability to heal itself with guidance. By choosing Break Free Physiotherapy and Wellness and trusting our team to help, we believe in a collaborative effort to find freedom from your pain. If you are interested in learning more about us, read our bios. If you would like to book with one of our skilled physiotherapist, click here to book now.
This is a dry needle. A thin solid needle that is disposed of after use.
Frequently Asked Questions
Here are some questions asked by a lot of my clients when it is their first time receiving dry needling.
What is dry needling?
Dry needling is a technique that uses thin filiform needle and carefully placed in a tight band of muscle. The reason why it is called “dry” needling is that nothing is injected or withdrawn from the needle. It is a solid stainless-steel needle.
Is it the same as acupuncture?
Acupuncture and dry needling use the same needles, but the application is different. Acupuncture needles are left in the muscles for 15-20 minutes; whereas in dry needling, the needle is inserted and removed immediately.
Where do you put the needle?
We will generally start at the spine and in the area that you are feeling soreness. We would also complete an assessment to determine any other possible sources of your pain. Sometimes its not as simple as treating the area that hurts. We look for other areas that could be contributing to your pain.
Does it hurt?
Most people report no pain. If the injury has been around longer, there may be soreness for up to 48 hours. The soreness almost feels like sore muscles after a good workout. Other times it may bring on new sensations like a buzz or tingle that should ease shortly or within the 48-hour period. For the first treatment of my back, I noticed that my leg felt slightly tingly, but it improved after a couple hours. The next day my back was slightly sore but the tingling in my leg was less frequent and less intense. Everyone’s experience will be different, but it is important to communicate how you feel after the treatment so your physiotherapist is aware.
How many times do I have to receive treatment to feel better?
It really depends on the individual. There are some that get treatment once and then their pain is gone. Others, like myself, require several treatments along with key exercises to get you back to doing what you love. My suggestion is to let your physiotherapist assess you first to try and answer that question together.
How does it feel?
Some people report a flicker of movement of the muscle followed by a relaxation of the tight muscle. This flicker or jump is a good sign – it indicates that something tight has been released. Others notice a buzz, burn, or tingling at the site of treatment. Others don’t notice anything at all. Your physiotherapist will be checking with you at all times to make sure you’re doing okay as the treatment continues.
Is it safe?
Physiotherapists have taken extensive coursework and have in depth knowledge of the human body. In order to learn this technique, they complete a written and practical exam in order to receive their certification in needling. Many hours of training and mentorship have been provided to our staff to ensure that you have a positive experience.
How big are the needles?
The size of the needle varies on the location of your body and how you are feeling. The needles are very thin unlike a syringe used to inject fluid. Your physiotherapist has ways of determining what type of needle must be used for certain areas of your body.
How many needles do you use?
Initially we may start with less depending on your experience with needles and how sensitive you are. If you are more sensitive and in pain, we may choose to do less. Whereas if you are doing well during the session, we may apply more. If it is your first time, we would try 1-2 first and check in before we continue.
Do you reuse the needles?
No. They are single use disposable ones. We may use the same needle for your body, but then dispose of it in a safe container.
When is it not appropriate to do dry needling?
You cannot receive dry needling if:
You are pregnant
There is a metal or plastic implant in the area
If you have a blood clotting disorder
You have a scar over the area we would like to needle
You have an active infection
Near swelling or have a condition that increases swelling like lymphedema
If you have a phobia of needles
Allergies with stainless steel or alcohol
Who is this treatment good for?
This treatment is great for:
People who have not had success with conventional treatments such as massage, stretching, or strengthening exercises
Longstanding injuries greater than 6 months (also known as chronic injuries)
Highly active individuals who exercise regularly
Those who have tried everything else with no change in their symptoms
If you feel that this treatment is for you, click here to book with us today!
