Case report: Electric dry needling for treatment of low back pain

From thounds of years, electricity used for treatment of pain such as Ancient Egyptians and later the Greeks and Romans recognized that electrical fishes are capable of generating electric shocks for relief of pain. The modern era of neuromodulation began in the early 1960s, first with deep brain stimulation which was soon followed (in 1967) by spinal cord stimulation, both for otherwise intractable pain. Dry needling is one of the common intervention used for low back pain of different origine. Electric current can be used in addition to dry needling in treatment of neuropathic and nociceptive type of pain by using percutaneous needles. Sixty years old female patient came with complaint of severe low back pain since two years on and off, which become persistent since last 1 month with increased pain intensity. Pain was diffuse, aching, stabbing type with numerical rating scale (NRS) score of 8/10 and score on pain detect tool was 18. Low back pain used to aggravate on prolonged sitting, standing in one place, and repetitive lifting and bending activities. MRI lumber spine suggestive of L5-S1 disc prolapsed posterocentral non compressing nerve roots with normal lumber canal. Based on these findings our provisional diagnosis L5-S1 disc prolapsed posterocentral with myofascial trigger points over gluteal region. For that tablet baclofen and etodolac for 2 weeks was prescribed but there was no significant relief i.e. patient reported NRS score 7/10 on follow up after 2 weeks. Subsequently intervention was planned. Dry needling with electric stimulation done for 60 minutes on bilateral gluteal region. On follow up visit after onemonth patient reported excellent pain relief with NRS sore of 1/10. Patient had good pain relief by the followup of nine months. Dry needling with electric stimulation increases duration of pain relief and cause some neuromodulation effect in low back pain.