Trigger Point Dry Needling
Demonstration of Dry Needling
What is dry needling?
Dry needling is an invasive procedure in which a solid filament needle is inserted into the skin and muscle directly at a myofascial trigger point. A myofascial trigger point consists of multiple contraction knots, which are related to the production and maintenance of the pain cycle.
Is dry needling similar to acupuncture?
There are many similarities and differences between dry needling and acupuncture. Licensed physical therapists in a growing number of states can use dry needling under the scope of their practice. Dry needling also falls within the scope of acupuncture practice. Physical therapists at are not licensed acupuncturists and do not practice acupuncture. In contrast to most schools of acupuncture, dry needling is strictly based on Western medicine principles and research.
How does dry needling work?
The exact mechanisms of dry needling are not known. There are mechanical and biochemical effects. Based on the pioneering studies by Dr. Jay Shah and colleagues at the National Institutes of Health, we know that inserting a needle into trigger points can cause favorable biochemical changes, which assist in reducing pain. It is essential to elicit so-called local twitch responses, which are spinal cord reflexes. Getting local twitch responses with dry needling is the first step in breaking the pain cycle.
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 and shoulder pain, arm pain (tennis elbow, carpal tunnel, golfer’s elbow), headache to include migraines and tension-type headaches, jaw pain, buttock pain and leg pain (sciatica, hamstrings strains, calf tightness/spasms). The treatment of muscles has the greatest effect on reducing pain mechanisms in the nervous system.
Is the procedure painful?
Most patients do not feel the insertion of the needle. The local twitch response elicits a very brief (less than a second) painful response. Some patients describe this as a little electrical shock or like putting tin foil in their mouth; 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.
Yes, we only use sterile disposable needles.
What side effects can I expect after the treatment?
Most patients report being sore after the procedure. The soreness is described as muscle soreness over the area treated and into the areas of referred symptoms. Typically, the soreness lasts between a few hours and two days. The severity of the soreness usually follows how active the trigger point was during treatment. Often, patients get no significant soreness.
Are there any after care instructions?
After your needling, I advise people to not "go crazy" with exercise as the muscles heal. It is beneficial to move around to promote better circulation. Otherwise, ice and self massage will help with soreness. If you feel you need to take an anti-inflammatory you can, but most patients report that they don't need it.
How long does it take for the procedure to work?
Typically, it takes several visits for a positive reaction to take place. Again, we are trying to cause mechanical and biochemical changes without any pharmacological means. Therefore, we are looking for a cumulative response to achieve a certain threshold after which the pain cycle is disturbed and lessened. But every patient is different; some get a great response right away, some require a few sessions.
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.