Dry needling has been quickly gaining in popularity over the last twenty years as a fast and effective method of relieving pain caused by various musculoskeletal conditions. Dry needling is performed by physical and occupational therapists who have completed advanced education and certification. Dry needling uses the same needles as traditional acupuncture but the theoretical foundation and the technique are completely different. Acupuncture is based on Traditional Chinese Medicine (TCM) principles whereas dry needling is based on Western medicine, physiology and trigger point release techniques. In contrast to wet needling, dry needling uses the insertion of a thin monofilament needle into a myofascial trigger point but no substance is injected. Intramuscular stimulation (IMS) is a type of dry needling which uses a different theoretical and practical approach targeted at the treatment of neuropathic pain.
What’s a trigger point?
A myofascial trigger point is an irritable nodule in a tight band of muscle fibers which limits the muscle’s ability to contract or elongate leading to different types of movement restrictions and/or pain. They are often referred to as knots and frequently felt in the upper back and shoulder area. The trigger point can be tender to touch and can refer pain elsewhere. The pain felt in a trigger point is due to hypoxia, or lack of oxygen, and decreased blood flow to the muscle tissue. Trigger points are caused by excessive stress put on muscle tissue whether that is from overuse (repetitive strain injury, poor posture) or an acute injury (whiplash, muscle strain).
How does it work?
During dry needing, the needle is inserted repeatedly into a trigger point to elicit a local twitch response (LTR). A LTR is an involuntary contraction in a taut muscle band which feels like a dull cramp or ache. This reaction will release the muscular tension and provide pain relief. The needle insertion also mildly damages the muscle fibers and leads to a small inflammatory response which helps heal the tissue. Dry needling will result in improvement of blood flow to the injured area, muscle elasticity, range of motion and performance. Some people will experience mild discomfort during the procedure and may feel a bruised sensation to the area for one or two days.
Who is it for?
A thorough assessment by a qualified physical or occupational therapist is required to determine if dry needling is suitable for someone’s specific needs. Dry needling is frequently used in the treatment of various musculoskeletal injuries including:
- Tension Headache
- Upper neck and shoulder tension
- Repetitive Strain Injuries
- Acute and chronic back pain
- Buttock pain
- Plantar fasciitis
- Muscle strains
The efficacy of dry needling highly depends on the skills and experience of the therapist performing it. Dry needling isn’t a stand-alone treatment but one of the tools used by therapists as part of a larger treatment plan aimed at relieving pain and restoring proper biomechanics to promote long lasting health.