What is dry needling?
Dry Needling, or Intramuscular Manual Therapy, is an invasive, neurophysiological, evidence-based treatment technique used to treat myofascial pain using in which a solid filament 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. When the needle is inserted into a contracture knot, the goal is to release or inactivate the trigger points and relieve pain.
Is dry needling similar to acupuncture?
There are few similarities and many differences between dry needling and acupuncture. The needle is the same and that’s where the similarities end. Licensed physical therapists in a growing number of states, including Wisconsin, can use dry needling under the scope of their practice. 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 needling are not known. 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.
What type of problems can be treated with dry needling?
Dry needling can be used for a variety of musculoskeletal problems. Myofascial pain and muscles are thought to be a primary contributing factor to the symptoms. Chronic and acute conditions include, but are not limited to neck, back and shoulder pain, arm pain (tennis elbow, carpal tunnel, golfer’s elbow), headache to include migraines and tension-type headaches, jaw pain, buttock pain and leg pain (sciatica, hamstrings strains, calf tightness/spasms). The treatment of muscles has the greatest effect on reducing 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 a little electrical shock; others feel it more like a cramping sensation. Again, the desired therapeutic response occurs with the elicitation of local twitch responses which is uncomfortable.
Are the needles sterile?
Yes, we only use sterile disposable 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 two days. The most common side effects are: Bleeding, bruising, pain during treatment, and pain after treatment. Uncommon AEs (under 1% of those treated) were aggravation of symptoms, drowsiness, headache, and nausea. Rare AEs (under 1/2% of those treated) were fatigue, altered emotions, shaking, itching, claustrophobia, and numbness.
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 heat or ice over the area, self-massage toward a joint, compression, 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 dry needling?
In the US, dry needling is a relatively new method for treating myofascial pain and not everyone is already aware of this very effective modality. Feel free to inform your doctor about this treatment option. It is upon all of us to educate others and each other about new and innovative ways to treat pain.
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 with acute and chronic pain in the clinic. More frequently, dry needling is needed in the beginning of treatment in order to break the pain cycle. Once that is achieved, other treatment options are introduced such as motor control training, medical exercise therapy, postural education and exercise, stretching, strengthening, and more advanced modes of exercise.
Once I am 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 chronic injuries.
Where can I get more information about the procedure and the people that are licensed to perform it?
Visit the Myopain Seminar home page www.myopainseminars.com for information, articles and frequently asked questions.