Combination of extracorporeal shockwave therapy and dry needling as treatment of disabling chronic low back pain: a case report

Abstract

Male patient, 55 years old, had a clinical background of lumbar radiculopathy and a surgical approach (L5-S1 discectomy and arthrodesis) in December of 2021, with complete resolution of associated pain. One year later, the patient seeks medical treatment, referring a new, different pattern of low back pain, which initiated post-surgery. The first treatment session began with focused extracorporeal shockwave therapy directed at the right quadratus lumborum, gluteus medius, gluteus minimus and peritrochanteric region.  Afterwards, dry needling was associated in trigger-points present in those same 3 muscles and also in the right sacrotuberal ligament, close to the insertion of the right gluteus maximus. In a reevaluation one week later, the patient reported a reduction of 70% of initial pain intensity. The same treatment was repeated, with complete resolution of symptoms at the end of the session. Three months later, the patient-maintained symptom control and fully recovered his previous functionality and quality of life. In this case of long-term functional limitation due to chronic low back pain, the combination of extracorporeal shock wave therapy and dry needling resulted in an effective and quick method to achieve pain relief and restore previous functionality. However, more studies are needed to investigate the impact of this combination of therapies in pain management and functionality loss due to chronic low back pain.