EFFECTIVENESS OF DRY NEEDLING ACTIVATION OF GLUTEUS MAXIMUS ON LOW BACK PAIN DUE TO GLUTEAL AMNESIA: AN EXPERIMENTAL STUDY

Abstract

Background
Low back pain is a common musculoskeletal condition that can limit daily activity, work participation
and quality of life. In many patients, persistent low back pain is influenced not only by lumbar spine
dysfunction but also by altered hip and pelvic muscle control. Gluteal amnesia refers to reduced or
delayed activation of the gluteal muscles, particularly the gluteus maximus. When the gluteus maximus
fails to activate efficiently, compensatory overuse of the lumbar extensors, hamstrings and surrounding
lumbopelvic muscles may increase mechanical stress on the lower back. Dry needling may help reduce
myofascial sensitivity and facilitate neuromuscular activation, especially when combined with a
progressive gluteus maximus exercise protocol.
Objective
To assess the effectiveness of dry needling activation of the gluteus maximus combined with a specific
exercise protocol on pain intensity, functional disability and gluteus maximus strength in individuals
with low back pain due to gluteal amnesia.
Methods
An experimental comparative study was conducted among 60 individuals with low back pain associated
with gluteal amnesia. Participants were divided into two groups of 30 each. Group A received a home
exercise program, while Group B received dry needling activation of the gluteus maximus along with a
structured gluteal activation and strengthening program. Outcome measures included Visual Analogue
Scale (VAS), Oswestry Disability Index (ODI) and gluteus maximus strength using manual muscle
testing. Pre-intervention and post-intervention values were compared using paired t-test and between-
group changes were analyzed using independent t-test. The level of significance was set at p < 0.05.
Results
Both groups showed statistically significant improvement after intervention. Group A demonstrated
reduction in VAS from 7.04 ± 1.06 to 4.93 ± 1.20, while Group B showed greater reduction from 6.72 ±
1.02 to 3.02 ± 1.17. ODI improved from 46.35 ± 7.98% to 32.43 ± 9.07% in Group A and from 46.94 ±
6.87% to 22.68 ± 9.31% in Group B. Gluteus maximus strength improved from 3.24 ± 0.35 to 3.94 ±
0.46 in Group A and from 3.12 ± 0.40 to 4.36 ± 0.42 in Group B. Between-group analysis showed
significantly greater improvement in VAS, ODI and gluteus maximus strength in Group B (p < 0.001).
Conclusion
Dry needling activation of the gluteus maximus combined with a specific gluteal exercise protocol was
more effective than a home exercise program alone in reducing pain, improving functional disability
and enhancing gluteus maximus strength in individuals with low back pain due to gluteal amnesia.