Muscle energy technique versus dry needling of quadratus lumborum in the treatment of myofascial trigger points

M.Tech. (Chiropractic)Purpose: The aim of this comparative study was to compare the effects of Muscle Energy Technique (MET) versus myofascial dry needling of quadratus lumborum in the treatment of myofascial trigger points (TrPs), with regards to pain, disability and lumbar spine range of motion. Method: Thirty participants, male and female between the ages of eighteen and forty-five years, with an active quadratus lumborum TrP were used in this study. The thirty participants were randomly divided into two groups consisting of fifteen individuals each, ensuring equal male to female and age ratios. Group 1 received treatment in the form of MET. Group 2 received treatment in the form of myofascial dry needling. The trial consisted of five visits over a treatment period of two weeks, of which the first four visits the participants received treatment and the fifth visit served the purpose of obtaining the final data. The data was gathered on the first, third and fifth visits. The data was gathered before the treatment was performed. Objective data consisted of measuring lumbar spine range of motion with a digital inclinometer and pain pressure threshold using an algometer. Subjective data was obtained by using the Numerical Pain Rating Scale (NPRS) and Oswestry Disablity Index for Lower Back Pain (ODI). Results: The results were interpreted by STATKON at the University of Johannesburg. Both groups improved significantly in both the objective and subjective measurements over the two week trial period. This indicted that both treatment interventions were effective in the treatment of active quadratus lumborum TrPs. The results also indicated that group 2 (myofascial dry needling) was statistically superior to group 1 (MET) with regards to the subjective and lumbar spine range of motion measurements obtained during the study. There was no statistical superiority between the two treatment interventions with regards to the pain pressure threshold values obtained. These results indicate that dry needling is more effective than MET in decreasing pain and disability, while increasing lumbar spine range motion due to active quadratus lumborum TrPs. Conclusion: It was concluded, based on the results, that myofascial dry needling was more effective than MET with regards to the subjective pain, disability and lumbar spine range of motion. However with regards to pain pressure threshold values, there was no superiority of either treatment. This study suggests that myofascial dry needling is a preferential treatment option than MET in the case of active quadratus lumborum TrPs as it is possible that dry needling alone is more effective in reducing pain, disability and increasing lumbar spine range of motion. However this does not rule out MET as treatment for active TrPs as objectively MET reduces objective pain as effectively as dry needling