Comparison of the effects of dry needling of the Medius and Hamstring muscles with the sciatic nerve neurodynamic technique on pain and nervous system mobility in people with chronic non-specific low back pain: A randomized (controlled) clinical trial

To compare the effects of dry needling of the gluteus medius and hamstring muscles, neurodynamic techniques, and their combination on referred pain intensity in the posterior lower limb, functional disability, and range of motion during the straight leg raise (SLR) test in patients with chronic nonspecific low back pain.

A three-arm, parallel-group, randomized clinical trial with allocation concealment and blinded outcome assessment and data analysis in 30 patients with chronic nonspecific low back pain.

Patients referred by neurologists, orthopedic specialists, or physical medicine and rehabilitation specialists will be screened for eligibility. After informed consent, demographic and medical data will be collected, and 30 participants will be randomly allocated to three intervention groups (10 per group). Outcomes will be assessed at baseline, after 10 treatment sessions, and at one-month follow-up. The outcome assessor and statistical analyst will be blinded to group allocation.

Age 18–65 years; chronic nonspecific low back pain lasting more than 3 months; VAS pain score of 3–7 and Oswestry Disability Index (ODI) score >20%; SLR test at 40°–70°; active trigger points in the gluteus medius and hamstring muscles; absence of musculoskeletal, neurological, systemic, serious internal diseases; no history of fractures or lumbar or symptomatic lower-limb surgery; no physiotherapy or dry needling of the target muscles within the previous 6 months; and no pregnancy.

Patients will be randomly allocated in a 1:1:1 ratio to three groups of 10 participants each: a neurodynamic group, a dry needling group, and a combined neurodynamic and dry needling group.

Pain intensity measured using the VAS, functional disability measured using the ODI, SLR range of motion.

In this study, 30 eligible patients will be randomly allocated to three groups of 10 participants each: a neurodynamic technique group, a dry needling group, and a combined neurodynamic technique and dry needling group, using block randomization with an allocation ratio of 1:1:1. The individual participant will be the unit of randomization. The random allocation sequence will be generated using statistical software with variable block sizes to maintain balance in the number of participants across the three groups. The generated random allocation sequence will serve as the basis for assigning each participant to an intervention group. To ensure allocation concealment, the allocation sequence will be placed in sequentially numbered, opaque, sealed envelopes. The envelopes will be opened in numerical order only after each participant's eligibility has been confirmed and their enrollment has been finalized, thereby preventing the group allocation from being anticipated in advance.

In this study, both the outcome assessor and the data analyst will be blinded to group allocation.

There is no further information.

Study Protocol: Effects of Dry Needling, Neurodynamic Techniques, and Their Combination in Patients with Chronic Nonspecific Low Back Pain. The document describes the study objectives, design, participant eligibility criteria, interventions, outcome measures, and assessment schedule. It will be made available upon reasonable request to the corresponding author after publication of the main study results, subject to applicable institutional and ethical requirements.

The study protocol will be available upon reasonable request starting from the date of publication of the main study results and will remain available indefinitely, subject to applicable institutional and ethical requirements.

The study protocol will be available to researchers and other individuals affiliated with academic institutions, research organizations, or other relevant organizations, upon reasonable request to the corresponding author.

Requests to access the study protocol should specify the intended research or academic purpose. Requests will be reviewed by the corresponding author to ensure that the proposed use is appropriate and consistent with applicable institutional and ethical requirements. The protocol may be used for academic, educational, or research purposes, provided that the document is appropriately cited and is not misrepresented.

Researchers interested in obtaining the study protocol should contact the corresponding author by email. Requests should include the applicant’s name, institutional affiliation (if applicable), and intended purpose of use. The corresponding author’s contact details will be provided in the published study report or can be obtained through the study registration record in IRCT.

Applicants should submit their request by email to the corresponding author, stating their name, institutional affiliation (if applicable), and intended purpose of use. The corresponding author will review the request and, if approved, provide the study protocol electronically by email. Requests will normally be reviewed within 14 working days, and the document will be provided within 30 working days of approval, subject to applicable institutional and ethical requirements.