January 11, 2018

Trigger Point Dry Needling

CFPH Trigger Point Dry Needling FAQ

 

What is dry needling?

Trigger point dry needling (TDN) is a specific treatment technique that uses a solid filament needle to treat muscle trigger points which create pain, discomfort and dysfunctional movements.

What is a trigger point?

A highly localized, hyper-irritable spot in a tight band of muscle tissue. These points located throughout the human body play a role in producing and sustaining feelings of pain. They are typically caused by an “energy crisis” most often brought about by injury, inflammation, muscle dysfunction, nervous system impairments and/or overuse. Studies show that trigger points were the primary source of pain in as many as 85% of pain-related appointments with a primary care doctor. Trigger points can be sources of persistent pain input and their inactivation is is consistent with current pain management strategies.

How does it work?

The mechanical stimulation of the muscles produces a local twitch response which then creates a change in the communication between the nerve and the muscle resulting in muscle relaxation. A decrease in pain could be related to this muscle relaxation and/or removal of compression on joint, nerve and vascular tissue. Often times, the insertion of the needle will reproduce referred pain/symptoms which is a positive sign confirming that the trigger point is indeed the cause of the pain. It is theorized that TDN also stimulates release of the bodies hormones and chemicals which initiates a new healing process.

Who is a candidate?

Anyone with specific joint, muscle and/or tendon pain regardless of the duration of symptoms.

What are common conditions treatment treated with this technique?

Trigger points have been identified in numerous diagnoses such as radiculopathies, joint dysfunction, disc pathology, tendonitis, TMJ dysfunction, headaches, carpal tunnel syndrome, computer-related disorders, whiplash associated disorders and pelvic pain. Validated of use of drying needling as an intervention against trigger points and pain have been successfully assessed in those with neck and back pain; sciatic pain; headaches; shoulder pain associated with tendinitis/rotator cuff pathology; foot pain/plantar fascitis; muscle pulls, strains and general soreness; knee pain; achilles tendon pain; hip pain; tennis elbow.

How is it different from acupuncture?

While TDN uses the same tool as acupuncture, it is with a different theoretical purpose. Acupuncture follows Easterns Medicine’s key principles of holistic treatment and is based on normalizing energy imbalance, or Chi, and often the needle is inserted to indirectly affect a different tissue. With TDN, the needle is directly inserted into the muscle we are trying to affect.

Is dry needling all I need?

VERY rarely is a standalone procedure and should be part of a broader physical therapy approach.

How effective is dry needling?

Typically, immediate changes are noted and so long as the initial stimulus for the trigger point is being addressed, long term changes can continue. Typically 3-4 sessions are recommended but this can vary depending the cause and duration of the symptoms and the overall health of the patient. Dry needling should not replace traditional physical therapy but be used as an adjunct.

Does dry needling hurt and how will I feel after?

Typically, patients will feel some level of discomfort during treatment but very short lived. Soreness may last from 1 to several hours however remaining active or heating the area may help reduce that soreness. This soreness varies person to person and depends on the body area treated. Minimal bruising may be noted. On rare occasions, a patient may feel tired, nauseous and/or emotional and typically only lasts 30-60 minutes post treatment.

Is it safe?

Precautions are used to minimize/eliminate risk through the use of a clean technique and extensive training on needle placement. Absolute contraindications include:

  • Bleeding/Clotting disorders
  • Active infection

What are the precautions?

These are not absolute reasons to avoid the use of TDN however caution will be taken in those with:

  • needle aversion or phobia
  • Local skin lesions
  • Local lymphedma
  • Severe sensitivity to pain
  • Nickel or chromium allergy
  • Abnormal bleeding tendency
  • Compromised immune system
  • First trimester of pregnancy
  • Vascular disease including varicose veins
  • Following surgical procedures where the joint capsule has been opened

 

For more information, please refer to http://www.apta.org/StateIssues/DryNeedling/ or feel free to email Lauren at lauren.hinrichs@gmail.com.