Trigger Point Dry Needling: An Overview

April 30, 2017

WHAT IS DRY NEEDELING:

This is one of the most common questions that patients or potential patients ask us when observing the services we offer at Integrity Physical Therapy.  Some individuals have heard of it from friends or family members that have had it done before, while others have no idea about what it is or why it is performed.  For the most part, people really don't know how or why it is performed.  As physical therapists a big part of what we do is educate patients on their impairment and how our treatment is effective in resolving their problems.  For this reason, we want to take a little time to educate you on what dry needling is, what it isn't, and how it helps in treating myofascial dysfunction.

WHAT DRY NEEDLING IS

Dry needling, also referred to as Trigger Point Dry Needling (TDN), is a technique used to treat myofascial pain with a solid filiform needle.  This technique uses a "dry" needle, one without medication, to be inserted through the skin into trigger points in muscles.  A trigger point is basically a band of dysfunctional muscle tissue that is usually the result of overuse, postural abnormalities, muscular imbalances, or nerve impingement.  Trigger points are frequently associated with tendinitis, bursitis, and neurological impingement of the spine among other things.

Dry needling actually stemmed from trigger point injections, where an anesthetic or corticosteroid is injected into a trigger point to induce relaxation.  Because there is a limit to how often such medication can be injected to the body, studies were developed to observe the response of a trigger point when just a needle was inserted. Once it was realized that just inserting a "dry needle" could create a similar response, a new form of treatment was developed.  One major finding was that the spontaneous electrical activity (SAE) of a trigger point (which is elevated compared to normal muscle tissue) is reduced from just the stimulation from the metal needle. Increased SAE at a trigger point is what keeps such tissue in a contracted state (muscle spasm), so this response allows the trigger point to relax to its normal resting tone.  In some cases this happens immediately, resulting in instant improvement in ROM, muscle tightness, and pain levels.  Other times it takes multiple treatments to achieve a lasting effect.

The technique only lasts a few minutes, most of which is setup time. Because we use sterile needles, gloves, and prepare the treatment area with alcohol, the risk of infection is minimal.  The primary risk of this procedure is causing a punctured lung (pneumothorax) when treating around the chest.  We can proudly say that in almost 10 years of combined experience with this technique, we have never had this happen!  What IS more common after this treatment is muscle soreness, which could last a couple days, or some bruising.

Dry needling can only be performed by a licensed healthcare professional who has passed the appropriate certification standards.  In the case of physical therapists, one must have two years of clinical experience before they can seek certification to perform dry needling.

WHAT DRY NEEDLING IS NOT

Dry needling is NOT acupuncture.  While we do use the same types of needles, our methodology and rationale is different than that of an acupuncturist.  Acupuncture depends on eastern medicine principles and use their map of the body (meridians) to guide their treatment.  Dry needling is based on western medicine principles and uses dermatomes and myotomes to guide its treatment plan.

Dry needling is NOT a "be all end all" treatment technique.  We use dry needling to facilitate our treatment plan.  It's not the only trick we have in the bag.  It is a great tool to eliminate myofascial pain, and once this is achieved, we can address whatever imbalance or deficiency was causing this pain more effectively.

Dry needling is NOT for everyone.  Some people are not appropriate to be "needled." A few types of patients that we would not include this treatment for include patients who have recently had surgery, patients who have phobias of needles, and patients whose pain is originating from something other than their muscles.  While we have observed over numerous years of practicing this technique that it is an excellent service to offer, we would never force someone to experience it if they are unwilling.  For that reason, we receive written consents from each patient that agrees to undergo this treatment.

HOW DRY NEEDLING CAN HELP YOU

Now that we have a better understanding about what dry needling is and what it isn't, let's talk about how it can help you.  We can actually use dry needling to treat just about any orthopedic issue that presents in our clinic.  From cervicogenic headaches to plantar fasciitis, TDN can help to manage a very wide variety of impairments. Anyone suffering from any bursitis, tendinitis, or muscle spasms from spinal derangement are excellent candidates for dry needling.  Because trigger points are actually dysfunctional muscle tissue, muscles which contain trigger points are not allowed to fire efficiently as they are intended, and this puts unwanted stresses on the supporting structures to which they are attached.  By "resetting" the muscle with TDN, the muscle is allowed to function as designed and the stress and inflammation on the bursa and tendon is relieved.

Results can happen instantly in many cases.  I have personally noticed that these cases have become much more easily treated since I have added this service to my regimen.  Common conditions that benefit especially from TDN include plantar fasciitis, tennis/ golfer's elbow, trochanteric bursitis (hip), subacromial bursitis (shoulder), rotator cuff tendinitis, IT band syndrome, Achilles' tendinitis, and patellar tendinitis.

We hope that this post has given you a better understanding about what dry needling is and how we use it in our clinic.  This overview just scratches the surface on TDN, and if you would like more information on it please call us at (985) 778-2540 or email us at info@integrityptla.com.  You can always check out our website as well, www.integrityphysicaltherapy.com

Thanks for your time, and have a great day!

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