WHAT IS DRY NEEDLING?
Trigger Point Dry Needling (TDN) is a valuable treatment used to influence neuro-musculoskeletal related pain and muscle function related to myofascial trigger points or tender points within a taut band of muscle. Trigger point dry needling is an invasive procedure in which a very small diameter, solid, filiform needle is inserted directly into a myofascial trigger point. A trigger point consists of multiple contraction knots, which are related to the production and perpetuation of the pain cycle. It is called dry needling because it does not involve injection a wet substance.
IS DRY NEEDLING THE SAME AS ACUPUNCTURE?
There are many similarities and differences between dry needling and acupuncture. Since 2010, licensed physical therapists in Wisconsin joined a growing number of states that allow the use of dry needling within the physical therapist scope of practice. Physical therapists 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 needing are not known. There are positive mechanical, biochemical and electrophysiologic effects.
We know that inserting a needle into trigger points can cause a favorable biochemical and electrophysiologic change, which assists
in reducing pain and improving motion. A local twitch response (LTR) may be elicited in the muscle which is a spinal cord reflex. Simply put, a LTR is a small, involuntary muscle contraction. Stimulating a LTR has been shown to be beneficial.
WHAT TYPES OF ISSUES CAN BE TREATED WITH DRY NEEDLING?
Dry needling can be used for a variety of neuro-musculoskeletal problems. Muscles are thought to be primary contributors to symptoms. Treatment of muscles has a great effect on reducing pain mechanisms in the nervous system as well as improving range of motion and tissue mobility.
Such conditions include but are not limited to:
• Neck/back pain, stiffness and/or range of motion
• Shoulder pain, stiffness and/or range of motion
• Arm pain, stiffness and/or range of motion (tennis elbow, carpal tunnel, golfer's elbow)
• Headaches: if muscle tension is a factor in both migraine and tension type headaches
• Buttock, hip, and leg pain, stiffness and/or limited range of motion
• Sciatica, hamstring or quadricep strains, illotibial band syndrome, plantar fasciitis
IS THE PROCEDURE PAINFUL?
Most patients do not feel the insertion of the needle. The needle inserted into healthy muscle tissue is not painful. When the needle is inserted into the trigger point (contraction knot), generally a deep aching/cramping sensation is felt. Sometimes a local twitch response is also elicited.
ARE THE NEEDLES STERILE?
Yes, only sterile disposable needles are used.
WHAT 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 a few days. Some describe the soreness as having a hard workout at the gym. Bruising can be a side effect. Refer to the consent form for additional side effects of treatment.
WHAT SHOULD I DO AFTER THE TREATMENT?
Make sure you drink plenty of water. Use a combination of heat/warm compresses and ice. A warm (or cold) shower can be very effective. Stretch and keep your body in motion. Go for a walk! Massage the tissue gently, and do not over-do your physical activity. Keep to 50% intensity for that day to allow the muscle tissues to heal.
Avoid: Excessive alcohol, unfamiliar sport or activity, activity that hurts or exacerbates your symptoms should be discontinued.
Avoid ibuprofen or other anti-inflammatory medications unless prescribed by your physician.
HOW LONG DOES IT TAKE FOR THE PROCEDURE TO WORK?
It may take several visits for a positive reaction to take place although frequently there are favorable results within session changes. 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 of change in either the pain cycle and/or mechanical/ROM improvements.
HOW OFTEN DO I NEED TO COME BACK TO MAINTAIN MY PROGRESS?
The musculoskeletal system is under constant pressure from gravity, stress, work, etc. Following TDN a regular exercise program including stretching and self-mobilization techniques combined with good posture, sleep, and eating habits can prevent further problems and maintain progress. If the pain or limited motion re-occurs, “tune-ups” may be required.
Simple range of motion restrictions, stiffness, or minor strains usually respond quickly to TDN. However, more complicated diagnoses/injuries may require a more comprehensive treatment plan.