Dry needling is a popular procedure whereby solid filament (acupuncture) needles are inserted into the skin and muscle directly at a myofascial triggerpoint.
A myofascial triggerpoint (sometimes known as a knot) consists of multiple contraction knots, which are related to the production and maintenance of the pain cycle.
The approach is based on Western anatomical and neurophysiological principles which are not to be confused with the Traditional Chinese Medicine (TCM) technique of acupuncture.
What can Dry Needling help?
Dry needling can be used for a variety of musculoskeletal problems. Muscles are thought to be a primary contributing factor to the symptoms.
Conditions which respond to dry needling include, but are not limited to:
- Frozen Shoulder
- Tennis elbow
- Carpal tunnel syndrome
- Golfer’s elbow
- Buttock pain
- Leg pain
- Hamstring strains
- Shin splints
- Muscle Spasms
- Sciatic Pain
- Hip Pain
- Knee Pain
- Repetitive Strain Injuries
How does Dry Needling work?
The exact mechanism is not known but there are mechanical and biomechanical effects. The pioneering studies by Dr Shah and colleagues at the National Institutes of Health (USA) suggest that inserting a needle into trigger points can cause favourable biochemical changes which assist in reducing pain. It is essential to elicit a Local Twitch Response which is a spinal cord reflex and is the first step in breaking the pain cycle.
- Something causes pain, if it happens often enough or if the trauma is great enough, the pain signal may return through the Sympathietic Ganglion and activate Primary Afferent Nocioceptors (H) which will feedback to the spinal cord. This will cause pain to continue instead of fade and is called a Reflex Arc.
- At the same time motor neurons may become stuck in a feedback loop/reflex arc, facilitating muscle spasm. In some cases the reflex arc continues for years, even decades.
- Introducing a new stimulus (i.e. the needle) impedes the reflex arc and has the effect of relaxing the muscle.
How does Dry Needling stop this cycle?
A spasmed muscle becomes a damaged muscle. Spasm reduces blood flow in the muscle. This means less oxygen and nutrients to the muscle. Muscle fibres die off and get replaced by fibrous scar tissue. This in turn holds the muscle tight, prevents muscle metabolites from leaving the muscle and causes continued spasm and pain.
Putting a needle into a spasmed muscle causes the muscle to relax, this can be seen with an electromyogram (EMG).
What does Dry Needling feel like?
Generally, needle insertion is not felt, the local twitch response may provoke a very brief pain response. This has been described as an electric shock or a cramping sensation. During treatment, patients commonly experience heaviness in the limbs or a pleasant feeling or relaxation.
The benefits of Dry Keedling frequently include more than just relief from a particular condition.
Many people find that it can also lead to increased energy levels, better appetite and sleep as well as an enhanced sense of overall wellbeing.
What should I do after Dry Needling?
Stretch the treated muscle as much as possible, 20 seconds by 4 at a time.
Are the Needles sterile?
Yes, only sterile disposable needles are used.
Are there any side effects?
Most patients report soreness in the treated area and referral zone lasting from a few hours to two days. Side effects are very rare but when they occur, the most frequent and the most serious is that of a pneumothorax. This is where a needle pierces the lung leading to a full or partial collapse. This happens mostly when a needle is inserted into the Trapezius muscle in a certain way and too deeply.
Can I do Dry Needling myself as part of my home programme?
No, dry Needling requires extensive training and should never be tried at home.
How long does it take for the procedure to work?
Typically, it takes several visits for a positive reaction to take place. We are trying to cause mechanical and biochemical changes without any medication. Therefore, we are looking for a cumulative response to achieve
a certain threshold after which the pain cycle is disturbed.
What if my GP is not familiar with Dry Needling?
Dry needling is a relatively new method of treating myofascial pain and not everyone is already aware of this effective modality. Feel free to inform your GP about this treatment option and the Clinic can be contacted for further queries.
Where does Dry Needling fit in the entire rehabilitation programme?
More frequently, dry needling is needed at the beginning to help break the pain cycle then other treatment modalities are introduced.
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 programme combined with good posture can prevent many problems. If the pain returns, “tune-ups” are recommended to treat and prevent injuries.