Dry Needling For Myofascial Trigger Points: Patient Information
- Myofascial trigger points are exquisitely tender points inside taut bands of muscle. They occur in overworked or traumatised muscles and contain noxious chemicals.
- They refer pain along recognised pathways and can be involved in conditions along their referral pathways.
- Dry needling is a technique used to release these trigger points.
- It involves inserting a very fine needle into the point and producing local twitch responses which result in release of the trigger point and a reduction of chemicals in the point. It is referred to as Dry needling as nothing is injected.
Dry needling is a technique where a solid, very fine needle is inserted into a soft tissue in the body.
Two techniques commonly used by physiotherapists are Superficial Dry Needling (SDN) and Deep Dry Needling (DDN). Both techniques are used in the treatment of pain and referred pain from myofascial trigger points MTrp but SDN can also be used for treating pain from ligaments and joints.
Superficial Dry needling involves inserting the needle into the superficial tissues above the MTrp, or subcutaneously over an affected area such as a ligament.
Deep Dry needling invloves inserting the needle into the actual MTrp where it may elicit a local twitch response LTR and facilitate release of the MTrp and taut band in the muscle. Deep Dry Needling is sometimes referred to as intramusclar stimulation.
What does Deep Dry Needling (DDN) involve?
DDN is carried out in this clinic by highly trained practitioners. It involves the use of sterile, single-use, disposable needles. The trigger point is palpated by the physiotherapist and a needle inserted into the point. The client will feel the LTR which feels like a local spasm or twitch in the muscle. This LTR may refer pain away from the trigger point, usually distally. The LTR may be elicited repeatedly or the needle may be ‘wound-up’ in the muscle to stretch the fibres. More than one needle may be used during a session, and the session may last between 5 and 20 minutes.
How does Deep Dry Needling differ from accupuncture and injections?
Accupuncture is based on the Chinese theory of Meridians, Balance of Yin and Yen, Energy flow etc. For a quick review click http://en.wikipedia.org/wiki/Acupuncture
Deep Dry Needling is Western based and widely researched. It is based on a theory of chemical build up in Myofascial Trigger Points
The technique used in each is not dissimilar but the theory and reasoning behind the treatment as well as the physiological outcome differs hugely.
The similarity lies purely in the use of similar needles which are extremely fine, sterile and flexible. They are usually around 0.15mm to 0.3mm in diameter.
Dry needling contrasts from injections where hollow hypodermic needles are used to inject substances such as a saline solution, a muscle relaxant such as botox or a corticosteroid into a tender point.
What are the aims of Deep Dry Needling treatment?
- Rapid relief of pain.
- Improve function.
- Relieve muscle spasm
When would Deep Dry Needling be considered as a treatment choice?
- Use as first line of treatment when patinet has active Myofascial Trigger points
- Use when patients symptoms are resistant to treatmentor
- Use as an adjunct to other physiotherapy techniques.
- Treat primary and secondary trigger points with other Muscle release techniques.
- Use diagnostically to identify referral sourses
- Chronic Pain
What are the side effects of Deep Dry Needling?
Some local side effects may occur:
- Muscle oedema
- Increased spasm or pain for 2-24 hours post treatment
- Short term nerve irritation
Some autonomic side effects may occur:
- Allergic reaction (very rare )
- Infection (very rare )
- Penetration of visceral organ ( very rare )
- Fainting / Dizziness