Abstract
Background. Chronic lower back pain contributes to the global disability burden, and continues to be a factor in the number of years spent disabled; Myofascial pain syndrome (MPS) is an inflammatory condition that may cause chronic localized pain and stiffness. Repetitive movements and incorrect posturing habits contribute to MPS advancement by formation of trigger points (TrPs) on the muscles.
Purpose. To investigate the impact of acupuncture dry needle versus progressive pressure technique on pain severity and pressure pain threshold (PPT) in patients with lower back MPS.
Methods. A randomized clinical trial. Thirty patients suffering from lower back MPS with the presence of TrPs on iliocostalis lumborum, quadratus lumborum, piriformis, and gluteus medius muscles were divided into two equal groups. Group (A) received acupuncture dry needle over TrPs followed by stretching exercise for 2 weeks (n = 15), and group (B) received progressive pressure technique over the same TrPs followed by stretching exercise for 2 weeks (n = 15). Pain severity and PPT at the TrPs were evaluated before and after treatment.
Results. There were statistically significant improvements in pain severity and PPT at the TrPs of the four muscles within both groups (p < 0.05), except the PPT at iliocostalis lumborum that showed a non-significant difference within group (A) (p > 0.05). Comparing both groups pre- and post-treatment showed statistically non-significant differences in all outcome measures (p > 0.05).
Conclusion. Both acupuncture dry needle and progressive pressure technique were effective in reducing pain severity and increasing PPT in patients with lower back MPS.

Keywords
acupuncture dry needle, progressive pressure technique, pain severity, pressure pain threshold, myofascial pain syndrome