Dry needling is an invasive procedure in which a solid filament, sterile disposable, 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.
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.
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.
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 Southeastern Physical Therapy 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.
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. The treatment of muscles has the greatest effect on reducing pain mechanisms in the nervous system.
Such conditions include, but are not limited to:
- Back Pain
- Neck Pain
- Shoulder Pain
- Arm Pain
- tennis elbow
- carpal tunnel
- golfer’s elbow
- Headaches to include migraines and tension-type headaches
- Jaw pain, including TMJ and TMD
- Buttock Pain and Leg 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 (less than a second) Neuromuscular 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. 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. Our recommendations vary depending on the amount of soreness you have and on the individual response to the treatment. Recommendations may include applying heat or ice over the area, gentle stretches and modifications of activities.
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. The musculoskeletal system is under constant pressure from gravity, stress, work etc. A regular exercise program combined with good posture can prevent many problems. If the pain comes back, “tune-ups” are recommended to treat and prevent serious injuries.
Where does dry needling fit in the entire rehabilitation program?
Generally speaking, dry needling is the modality of choice when it comes to treating patients in the clinic. More frequently, dry needling is needed in the beginning in order to break the pain cycle. Once that is achieved, other treatment options are introduced.