What is it?
Myofascial trigger point dry needling, also referred to as intramuscular stimulation, is a treatment used to restore proper function to abnormally behaving muscles. Knots and tight bands that develop in the muscle create localized pain or send pain signals to other locations. The affected muscles become hypertonic or locked and cannot function normally, which restricts movement and causes chronic pain.
The needles used are the same that are used in the practice of acupuncture.
This differs from “injection needling” which utilises a hypodermic syringe and usually involves the injection of an agent such as saline, local anaesthetic, botox or corticosteroid into the tissue or specific anatomical structures.
Dry needling is one of the most powerful modalities in treating soft tissue dysfunction.
Dry needling can help relieve the pain experienced by people with trigger points; however, it is not a stand-alone treatment, rather is used as part of a comprehensive treatment plan, culminating other treatments such as massage, stretches, strengthening, postural training and stabilization which all aid in improved flood flow to muscles, therefore reducing the occurrence of trigger points.
How does it work?
Knots can develop in muscles from overuse, trauma, poor posture, lack of exercise, sleep disturbances, vitamin deficiencies, joint arthritis or nerves compressed at the spine and other locations.
These painful areas contain biochemicals that cause pain to the local nerves and decreased oxygen flow, or ischemia, which causes the muscle fibers to become hypertonic or locked, which causes more biochemicals to be released and so the pain cycle continues.
Dry needling short-circuits the vicious pain cycle in a very direct way. The muscle contracture releases to its normal length, circulation is improved, swelling recedes and the pain-causing biochemicals disperse, eliminating their noxious effect on local nerves, the relief is often rapid with a reduction in pain and improved function.
Dry needling is an effective treatment for acute and chronic pain, rehabilitation from injury, and even pain and injury prevention, with very few side effects. This technique is unequalled in finding and eliminating neuromuscular dysfunction that leads to pain and functional deficits.
How is it performed?
When I do any musculoskeletal examination and find soft tissue problems—a muscle that’s doing too much or not enough— as a massage therapist, I can use my thumbs, fingers, elbows, stretching, mobilization or KinesioTaping to alter the state of the muscle.
Now I have added another tool with dry needling. I’ve seen some amazing results, and my clients who have experienced it often ask for needles when they feel the muscle tension is too much. In combination with massage and my other modalities dry needling can take a treatment to a whole new level and it will be staying as one of the most powerful techniques in my toolbox.
Most people do not feel the needle go in, but once into the heart of the problem, especially if the muscle that is sensitive and shortened, or has an active trigger point the feeling is similar to a strong muscular cramp or a deep ache, and the muscle may twitch in response, which can sometimes increase the feeling or refer it to another area.
Dry needling can be performed in two ways. Superficial dry needling is where the needle is inserted into the tissue above a trigger point and left for a short period of time.
Deep dry needling is where the needle is inserted into a trigger point, and then moved in and out of the trigger point to get multiple twitch responses in the muscle. This deactivates each part of the trigger point that was penetrated.
Where your therapist learnt their technique will depend on the style of needling they use. Some are taught to use only the more aggressive deep dry needling, and others, like myself, have been taught to use a combination of both.
What does it feel like?
The needle used is a thin filament, and most people barely feel it penetrate the skin.
A healthy muscle feels very little discomfort with needle insertion; however, if the muscle is sensitive and shortened or has active trigger points within it, as it penetrates the trigger point, the muscle fibers resist the needle and may cause a twitch response.
This can elicit a deep ache, sharp referred pain or a sensation similar to muscle cramp. The muscle twitching is an important part of the treatment, showing that the endplates are being stimulated, resulting in deactivation the trigger point, reduction of pain and restoring normal length function to the involved muscle.
What can it help?
Reduce knots and tension in muscles Aid in the healing of overuse injuries
Help muscles heal quicker after injury Release tight muscles
Improve blood flow at a deep level Stimulate a muscle to more effectively
Reduce the discomfort of chronic injuries Aid in scar tissue healing/realignment
in muscles, tendons and joints
How does it differ from acupuncture?
Dry needling uses acupuncture needles to target specific painful spots in muscles called trigger points.
Acupuncture comes from Traditional Chinese Medicine and uses acupuncture needles to eliminate painful spots in muscles by needling distal acupuncture points, which stimulate the energy flow to eliminate the blockage that causes the pain and by needling local tender spots in muscles – called ‘Ashi’ points.
Are there any safety concerns?
Dry needling is considered an invasive procedure in which a sterile acupuncture needle is inserted in to the skin and muscle. The risk of bleeding is minimal, though occasionally you may have a spot of blood show where a needle has been removed. This can often result in a small bruise.
I am registered with the NZ Blood Service as an approved provider. This means that you can continue to give blood as normal, 12 hours or more after the treatment has been given, as I only use sterile, single-use (disposable) needles.
If you received dry needling or acupuncture from someone who is not registered with the NZ Blood Service, there is a 6 month stand down period since your last session.