Informal Case Study #1: Dry Needling Misses the Mark for Acute Lumbar Disc Herniation

Lumbar Disc Herniation

An active male in his early 30s presents to a clinic with an acute lumbar disk herniation.  He was referred to another physical therapy office to begin care.  Physical therapy treatment at this office consisted mainly of dry needling, a relatively new, experimental, and popular treatment that consists of placing acupuncture needles into muscle trigger points.  During this time, he also was recommended to have back surgery as he did meet the criteria to have this procedure.

He did not respond well to dry needling and was trying to avoid surgery.  He began searching for other options.  He came to Metropolitan Physical Therapy unable to work, unable to fully stand up straight, experienced difficulty sleeping, and severe leg pain.   He was placed into a treatment plan that is supported in the medical literature, including manual therapy, specific low back exercises, and traction.   In addition, he received two injections into his spine from his pain management physician.

His treatment followed the expected course of a disc herniation and he was able to fully return to work with no symptoms.

Conclusions: 

  • Pragmatic and science-based approaches to lumbar disc herniation are preferable to untested and experimental treatments programs.
  • Choosing a physical therapy practice that understands how to appropriately manage spine conditions makes a huge difference in outcomes.
  • A comprehensive exam with the correct physical therapy practices can decrease the odds of seeking or needing a surgical procedure.