By: Dr. Ryan McDevitt, PT, DPT
Trigger point dry needling is a physical therapy technique that decreases pain in your muscles. Our goal, as PTs and musculoskeletal specialists, is to restore normal muscle and joint function. The dry needling technique is used in conjunction with a comprehensive evaluation that complements other treatment techniques to decrease pain and restore function.
Dry needling physical therapy uses a solid filament needle to treat muscle trigger points. These points are a highly localized, hyper-irritable spot in a taught band of skeletal muscle fibers. Many people know them by their more common name—the infamous “knot.” These muscle trigger points play a role in producing and maintaining the pain cycle. They can alter muscle performance, as well as generate pain along common referral patterns. These points develop in muscle for various reasons, including referred or local pain, inflammation, athletic injury or other causes.
How Does Dry Needling work?
The intramuscular stimulation produces a local twitch response or rapid depolarization of muscle fibers. After this process, the muscle activity dramatically reduces, which results in relaxation and decreased pain and dysfunction. This decrease in pain is related to the removal of muscular compression on your joint, nerve, and vascular tissue. Sometimes, the insertion of the needle also reproduces “referred pain” symptoms. This is a positive sign confirming the trigger point as the source of the pain. Dry needling is highly effective for chronic muscle and repetitive sport injuries.
What type of problems can be treated with dry needling?
Dry needling can be used for a variety of musculoskeletal problems. Muscles are thought to be a primary contributing factor to the symptoms. Such conditions include, but are not limited to:
• neck/back/shoulder pain
• tennis elbow
• carpal tunnel
• golfer’s elbow
• tension headaches and migraines
• jaw pain
• hamstrings strains
• calf tightness/spasms
Is the procedure painful?
Most patients do not feel the insertion of the needle. The local twitch response elicits a very brief painful response. Some patients describe this as a little electrical shock; others feel it more like a cramping sensation. Again, the therapeutic response occurs with the elicitation of local twitch responses and that is a good and desirable reaction.
What is the difference between dry needling and acupuncture?
The dry needling technique uses the same size needle that acupuncture uses, but with a different theoretical purpose. Traditional Chinese medicine practitioners use the holistic treatment of acupuncture to normalize energy, or Chi, in the body to cure syndromes. Although an acupuncture needle is used in dry needling, dry needling is based on traditional reasoning of Western medicine. The sites for the needle insertion are located in specific myofascial trigger points in skeletal muscle, which can differ from acupuncture.
How is Dry Needling Different from Trigger Point Injection?
Trigger point dry needling does not deliver any medication, hence the term “dry”. Therefore, the treatments can be done more frequently with no adverse side effects. Traditional trigger point injections use a hollow, hypodermic needle to inject substances such as saline, Botox or corticosteroids. The theory suggests that the “needling effect” is the most important part of the process rather than the chemicals injected. This does not mean that certain patients will not have greater benefits with injections rather than dry needling and vice-versa.
Why is my doctor not familiar with dry needling?
In the US, dry needling is a relatively new method for treating myofascial pain and not everyone is already aware of this effective modality. Feel free to inform your doctor about this treatment option. It is upon all of us to educate others about new and innovative ways to treat pain.
Ryan McDevitt, PT, DPT
3 Dimensional Physical Therapy
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