The Sympathetic and Clinical Effects of Dry Needling to the Thoracolumbar Junction Multifidi: A Randomized Controlled Trial

Authors

Nicole Clark, University of Saint MaryFollow
Cheryl J. Hill, Nova Southeastern UniversityFollow
Joshua Cleland, Tufts University School of MedicineFollow
Thomas Massie, Ability KCFollow
Shane Koppenhaver, Baylor UniversityFollow

Abstract

Purpose: The primary aim of this study was to investigate the neurophysiological effects of dry needling (DN) to the thoracolumbar junction multifidi when compared with a placebo. The secondary objective was to determine if there is a relationship between post-treatment pain and disability and the magnitude of sympathetic nervous system activity. Methods: Participants were eligible if they had low back pain, limited flexibility in at least one hamstring, and had not previously received DN. Participants completed the Numeric Pain Rating Scale and Oswestry Disability Index, underwent pressure pain threshold testing, and were randomized to a DN or sham DN group. Electrodermal activity (EDA), skin temperature, and pulse rate variability were obtained immediately before and after treatment. Participants returned after 24-hours to complete questionnaires and for SNS monitoring. ANCOVAs were used for the analysis of each variable of SNS activity. Pearson’s r was used to determine if immediate SNS outflow correlated with clinically meaningful improvements. Results: Fifty-four participants presenting with low back pain and decreased hamstring length participated in this study. EDA increased in the DN group, and between-group differences in EDA were significant immediately post-treatment but not at follow-up. Post-treatment SNS activity did not correlate with pain and disability ratings at follow-up. Changes in EDA imply that DN has a sympatho-excitatory effect. Conclusions: DN to the thoracolumbar junction may have an immediate sympatho-excitatory effect in the lower extremity; however, the magnitude of the effect was not associated with clinically meaningful changes after 24 hours.

Author Bio(s)

Nicole G. Clark, PT, MSPT, PhD is an assistant professor at the University of Saint Mary Stefani Doctor of Physical Therapy Program in Leavenworth, KS.

Cheryl J. Hill, PT, MS, DPT, PhD is a professor of physical therapy at Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine in Fort Lauderdale, FL.

Josh Cleland, PT, PhD, FAPTA is a professor of physical therapy at Tufts University Department of Rehabilitation Sciences in Boston, MA.

Thomas Massie, PT, DPT is a physical therapist at Ability KC in Kansas City, MO.

Shane Koppenhaver, PT, PhD, FAAOMPT is a professor of physical therapy at Baylor University Doctor of Physical Therapy Program in Waco, TX.

Recommended Citation

Clark N, Hill CJ, Cleland J, Massie T, Koppenhaver S. The Sympathetic and Clinical Effects of Dry Needling to the Thoracolumbar Junction Multifidi: A Randomized Controlled Trial. The Internet Journal of Allied Health Sciences and Practice. 2026 Mar 03;24(1), Article 1.