trigger point dry needling

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Trigger point dry needling

Have you ever felt those sore knots or bands of tissue in one of your muscles? Those are areas of a muscle that are dysfunctional. The reasons Physical Therapists (PTs) want to treat these areas of muscle are numerous. To start, they can generate pain themselves. They are chemically and electrically different than normal muscle tissue. They send erroneous information to your brain that keeps them in that contracted state. They can place constant tension on their associated tendons or nearby structures such and nerves. This can cause tendon irritation and can make the muscle less flexible. And if that wasn’t enough, because they stay contracted all the time, when you go to use that muscle the contracted portion cannot help. Basically, the muscle is weaker and inefficient. It is painful and dysfunctional. Often these areas of muscles are called trigger points, especially if they refer pain to another area. A sore neck muscle can cause a headache, for example. Most patients agree with their PTs and want these areas of muscle addressed.

PTs have many tools in their toolbox that can address these bands of muscle. We can use various forms of massage and soft tissue release, we can teach you proper stretching and strengthening exercises, and we can use a technique called Trigger Point Dry Needling.

At its most simple, dry needling involves the insertion of a thin, solid needle without medication into the dysfunctional muscle tissue. The needle is sometimes moved in order to elicit a deep ache, cramp, and/or muscle twitch resulting in the band of tissue relaxing and returning to a normal state.   By addressing the dysfunctional tissue immediate improvement in range of motion, flexibility, and strength as well as reduction of pain can be achieved.

Since I have started utilizing Trigger Point Dry Needling in my own practice I have seen amazing results. To help you understand more about this treatment, here are the most common questions I have been asked:

Is this a stand-alone treatment? Can I just have the needling done and not worry about the other PT treatments?

Dry needling addresses the “what” but not the “why”. Dry needling will help relax the knot in the muscle but it won’t address faulty movement or poor posture that caused the issue in the first place. Here’s another example: let’s say you gain a lot of motion in your shoulder, motion that you haven’t had for a few months, after dry needling. You are most likely weak in that new range of motion and without working on specific exercises your shoulder will most likely reset to its previous state.

So, yes, you can just get dry needled. But the results most likely will not last without correcting the other aspects of why you sought PT in the first place. Dry needling is just one component of a comprehensive physical therapy plan of care.

Is Trigger Point Dry Needling like Acupuncture?

Dry Needling’s similarity with Acupuncture begins and ends with the type of needle used. It’s the same needle used in a different way with different goals in mind. Examples of PT goals include increasing motion, building strength, and improving movement. Acupuncture goals include promoting and restoring a patient’s balance of energy. A PT may insert a needle into a muscle in the back of your shoulder to improve your rotator cuff strength. An Acupuncturist may place a needle in the same place but the goal is to improve your heart function and health. Put in other words, both a plumber and a carpenter may use a hammer but to build something different. The application of the needle is only one small part of the education and training of both professions.

Does Trigger Point Dry Needling Hurt?

Yep. You can expect to feel a deep cramp or ache that is slightly more intense than what you have experienced when somebody has firmly pressed or pinched the same area. You most likely will experience an involuntary muscle twitch that is more surprising than it is painful.

Do PTs have to go through extra training in order to perform Trigger Point Dry Needling?

Yep. In Utah, a PT has to have been practicing for 2 years and undergoes lots of training hours and multiple certification exams.

Is it dangerous or are there any side effects?

Any complication or danger is rare and can be mitigated by clean and safe technique. The biggest concern is puncturing a lung. In the training I underwent, we never pointed the needle towards the lung unless there was bone between the lung and the needle. Essentially providing a hard barrier preventing the needle from reaching the lung. In areas where the bone is thin, we go parallel to the body so the needle isn’t directed toward the lungs. That being said, the risk is there. If you are having dry needling treatment, discuss this with your PT and how they make sure that you are safe. If you feel uncomfortable with their response or are still nervous, tell them and ask them to use a different technique. This is not a mandatory treatment. You are in charge!

The most common side effect is muscle soreness. Sometimes you might bruise or bleed a little but this is does not happen at every treatment or in every area. Personally, this happens maybe 1% of the time.

Are there studies that have been performed on Dry Needling’s effectiveness?

Several studies have looked at the tissue level changes that occur with dry needling. All of which show improved tissue qualities. More and more studies are being performed on the effect of dry needling on specific medical diagnoses. Many of which are showing that trigger point dry needling results in improvements similar to the use of manual trigger point release. Personally, I don’t disagree with these studies. However, in my practice, Trigger Point Dry Needling seems to result in improvement faster. But that doesn’t mean that I can’t achieve similar results with more time by working on the tissues with my hands. This is good news for patients. If you are scared of needles, you have other options to help you.

 

Blog post provjannamannided by Janna Mann DPT.

Janna is a Physical Therapist that practices at Alpine Sports Medicine in Park City, UT. She graduated with a doctorate from the University of Utah in 2008 and is certified in trigger point dry needling. To schedule an appointment with Janna call 435-645-9095. A link to her clinics web site is provided here.