Efficacy of Dry Needling for Releasing the Sacrotuberous Ligament in Patients With Sacroiliac Joint Dysfunctions

NCT07550933 | Not Yet Recruiting DMC

• 1 other identifier: UniversitySWRS
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

Sacroiliac joint dysfunction is a common source of low back and pelvic pain, often caused by improper load transfer through the pelvis. The sacrotuberous ligament stabilises the sacroiliac joint by limiting sacral nutation and supporting posterior pelvic structures. The sacroiliac joint connects the sacrum to the ischial tuberosity and integrates with muscles like the gluteus maximus and biceps femoris. Tightness, dysfunction, or pain in the sacrotuberous ligament can exacerbate sacroiliac joint dysfunction by altering mechanics. Dry needling is increasingly used for myofascial pain and muscle dysfunction. Applying dry needling to release ligamentous structures is novel and may improve the biomechanics of the sacroiliac joint by alleviating tension in the sacrotuberous ligament. The aim of the study is to investigate the efficacy of dry needling for releasing the sacrotuberous ligament in patients with sacroiliac joint dysfunctions on pain intensity, functional disability, and biomechanical changes, along with routine physical therapy compared to sham dry needling and routine physical therapy.

Conditions

Sacroiliac Joint Dysfunction

Keywords

Sacroiliac joint dysfunction; dry needling; physical therapy; sacrotuberous ligament

Outcome Measures

Primary Outcomes (3)

• Numeric Pain Rating Scale

  The numeric pain rating scale (NPRS) is a validated subjective measure for acute or chronic pain assessment. Scores are based on self-reported measures of symptoms that are recorded by making a mark on a 10-cm line that represents a continuum between "no pain" and "worst pain."

  Six months

• Body Mass Index

  Height in cm, weight in kg

  six months

• Age

  Age in years

  six months

Secondary Outcomes (3)

• Biomechanical Changes

  Six months

• Oswestry Disability Index

  Six months

• Biomechanical Changes

  Six months

Study Arms (2)

1. Group B: Sham Dry Needling

EXPERIMENTAL

Patients will receive sham dry needling plus routine physical therapy.

Other: Group B: Sham Dry Needling

2. Group A: Dry Needling

EXPERIMENTAL

Group A: Intervention Group: Patients will receive dry needling targeting the STL plus routine physical therapy.

Other: Group A: Dry Needling

Interventions

Group A: Dry Needling OTHER

In Group A, Dry needling of the STL will be performed with the patient in a prone position, supported with a pillow under the abdomen to minimize lumbar lordosis. After antiseptic skin preparation and adherence to infection-control protocols, sterile, single-use filiform needles (0.25-0.30 mm gauge, 50-75 mm length depending on patient body habitus) will be applied. Anatomical landmarks, including the posterior superior iliac spine, sacrum (S3-S5), and ischial tuberosity, will be palpated to identify the taut band of the ligament. Needle insertion will be carried out obliquely or slightly medially at a 30-45° angle, with a penetration depth of approximately 4-6 cm, adjusted according to individual anatomy and confirmed where possible by ultrasound guidance to enhance precision and safety. One to two needles will be inserted per symptomatic side, with bilateral treatment applied when indicated. Each needle will be retained for 30-60 seconds with light pistoning if required

2. Group A: Dry Needling

Group B: Sham Dry Needling OTHER

Identify anatomical landmarks (PSIS, ischial tuberosity, S3-S5) and palpate the STL region exactly as in active DN. Place the introducer tube against the skin at the planned point(s); tap the top of the (blunt/retractable) needle as if inserting. For a fixed blunt-needle sham: insert the guide tube, then tap a blunt needle that is fixed inside the tube so it does not penetrate the skin (the subject feels pressure and tapping). For a retractable needle (Streitberger/Park): perform the same steps; the needle telescopes into handle on contact so skin is not pierced. Simulate identical manual manoeuvres (light pistoning or gentle manipulation of the introducer) for the same time as active DN (e.g., 30-60 sec). If the active protocol uses ultrasound guidance, simulate ultrasound probe contact and display but do not show images to the patient. Apply similar post-procedure care (pressure, dressing if used, reassurance).

1. Group B: Sham Dry Needling

Eligibility Criteria

• Age: 40 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Diagnosed patients having symptoms of sacroiliac joint dysfunction
• Both genders
• Age 40-65 years
• Standard clinical tests positive (Fortin finger test, Patrick's test)
• Imaging (MRI/X-ray)

You may not qualify if:

• Patients with a previous history of fracture
• Prior SIJ surgery
• Osteoporosis
• Pregnancy or post-partum
• Lumbar disc herniation
• Carcinoma
• Dislocation in the lower back and lower extremity
• Spinal stenosis that may cause pain in the lower back and hips
• Piriformis syndrome
• Lumbar radiculopathy
• Existence of known osteoporosis
• Metabolic diseases
• Severe cardiovascular disease
• Uncontrolled hypertension
• Severe renal diseases

Sponsors & Collaborators

• University of Social Welfare and Rehabilitation Science: lead

Study Sites (1)

CMH Medical College and IOD, Lahore, Pakistan

Lahore, Punjab Province, 54570, Pakistan

Location

Related Publications (1)

• Koppenhaver SL, Weaver AM, Randall TL, et al. Effect of dry needling on lumbar muscle stiffness in patients with low back pain: A double blind, randomized controlled trial using shear wave elastography. Journal of Manual & Manipulative Therapy 2022; 30(3): 154-64.

  RESULT

Related Links

• Google Scholar

Study Officials

• Syeda Arooj Fatima, PhD

  University of Social Welfare and Rehabilitation Science

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Dr. Fatima, PhD

CONTACT

+92 341 4391882; editor@thehealerjournal.com

Syeda Arooj Fatima, PhD

CONTACT

+92 323 2274767; aroojfatimapt@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Dr., Professor, Post-Doc Fellow

Model Details: Double-blinded, parallel-group, randomised controlled clinical trial

Study Record Dates

• First Submitted: April 5, 2026
• First Posted: April 24, 2026
• Study Start: April 1, 2026
• Primary Completion (Estimated): July 1, 2026
• Study Completion (Estimated): November 1, 2026
• Last Updated: April 24, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)