Effectiveness of Dry Needling Versus Conventional Exercise Therapy on Pain, Functional Disability, and Sleep Quality in Patients with Chronic Low Back Pain: A Randomized Controlled Trial

Abstract

Background: Chronic low back pain (CLBP) is a leading cause of disability worldwide, often associated with impaired function and poor sleep quality. Exercise therapy is a recommended first-line treatment, yet adherence and response rates vary. Dry needling (DN) has emerged as a potential adjunct, though evidence regarding its impact on sleep quality and its effectiveness in South Asian populations remains limited. Objective: To compare the effectiveness of dry needling versus conventional exercise therapy on pain intensity, functional disability, and sleep quality in patients with CLBP. Methods: In this randomized controlled trial, 78 patients with nonspecific CLBP were allocated equally to DN or exercise therapy. DN involved twice-weekly sessions targeting lumbar and gluteal myofascial trigger points, while the exercise program included stretching, strengthening, and stabilization exercises. Both interventions lasted four weeks. Outcomes included pain intensity (Visual Analogue Scale, VAS), disability (Oswestry Disability Index, ODI), and sleep quality (Pittsburgh Sleep Quality Index, PSQI). Data were analyzed using intention-to-treat principles, with effect sizes and 95% confidence intervals reported. Results: DN yielded greater improvements than exercise in VAS (–4.1 vs. –2.9; p < 0.01), ODI (–24.8% vs. –18.4%; p < 0.01), and PSQI (–5.1 vs. –3.6; p < 0.05). Between-group effect sizes were large for pain (d = 0.95) and disability (d = 0.91), and moderate-to-large for sleep quality (d = 0.71). Conclusion: Both interventions improved outcomes in CLBP, but DN produced superior short-term benefits. Integration of DN into multimodal rehabilitation may enhance recovery, though long-term studies are warranted.