Trigger Point Dry Needling

What is Trigger point dry needling?

This is an invasive procedure in which a thin, filiform needle is inserted into the skin and muscle directly at a myofascial trigger point. Physical therapists utilize dry needling in the treatment of myofascial pain. A trigger point consists of multiple contraction knots, which are related to the production and maintenance of the pain cycle.

Is trigger point dry needling similar to acupuncture?

Acupuncture is a key component of ancient Chinese medicine in which, needles are inserted into points along meridian lines which represent body's organs. Dry needling on the other hand are inserted into trigger points, they elicit a response that releases the trigger point and restores normal function. Dry needling is used to treat cases of acute and chronic pain.

How does trigger point dry needling work?

The exact mechanisms of trigger point dry needling are unknown. There are mechanical and biochemical effects. Based on the pioneering studies by Dr. Jay Shah and his colleagues at the National Institute of Health, we know that inserting a needle into a trigger point can cause favorable biochemical changes which assist in reducing pain. It is essential to elicit the so called local twitch responses, which are spinal cord reflexes. Getting local twitch responses with trigger point dry needling is the first step in breaking the pain cycle.

What type of problems can be treated with trigger point dry needling?

Trigger point 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 including migraines, tension type headaches, jaw pain, buttock pain, leg pain (sciatica, hamstrings strain, calf tightness/spasms). The treatment of muscles has the greatest effect on reducing the 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 an electric 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.

Are the needles sterile?

Yes, we only use sterile 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 2 days.

What should I do after having the procedure done?

Our recommendations vary depending on the amount of soreness you have and on the individual response to the treatment. Recommendations may include applying 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.

Why is my doctor not familiar with trigger point dry needling?

In the US, trigger point 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.

Where does trigger point dry needling fit into the entire rehabilitation program?

Generally speaking, trigger point dry needling is the modality of choice when it comes to treating patients. More frequently, trigger point dry needling is needed in the beginning in order to break the pain cycle. Once that is achieved, other treatment options are introduced.

Once I'm feeling better, how often do I need to come back to maintain my progress?

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.