The term dry needling is used to differentiate the use of needling in the western physiological paradigm from the use of needling in the oriental paradigm, referred to as acupuncture.
What is Dry Needling?
Dry needling involves inserting an acupuncture needle into a trigger point. A trigger point consists of multiple contractions within a muscle belly forming a knot. They are often tender and feel painful when pressed or squeezed. These trigger points are related to the production and maintenance of the pain cycle.
Dry needling can be used for a variety of musculoskeletal problems. 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. Some studies have suggested that inserting a needle into trigger points can cause favourable biochemical changes which assist in reducing pain.
A typical scenario might be a patient who presents with recurrent elbow pain (eg. tennis/golfers elbow). The trauma to the elbow from playing their sport, and the resultant pain signal, may have created what is known as a Reflex Arc. In short, a reflex arc is like a feedback loop that facilitates muscle spasm. In some cases the reflex arc may continue for years, or even decades. By introducing a new stimulus (the needle), this impedes the reflex arc and can relax the muscle.
Muscle spasm reduces blood flow in the muscle which means less oxygen and nutrients to the muscle. The resultant effect is a dying off of fibres and replacement 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 not only causes the muscle to relax, but also encourages blood flow within the structure.
What is it like having this treatment?
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. Personally, in the past when I have had this treatment, it has never been painful.
Following a treatment, most patients report moderate soreness in the treated area and referral zones 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 (shoulder) too deeply.
Typically, it requires several visits for a positive reaction to take place. The objective is to facilitate mechanical and biochemical changes without any medication. In turn a cumulative response is necessary to achieve a certain threshold after which the pain cycle is disturbed.
Dry needling is now available at Cartwright Pysicaltherapy. Tom undertaken study in this area especially for helping his patients with tennis and golfer’s elbow and other tendonopathies.
*DISCLAIMER: This discussion does not provide medical advice. The information, including but not limited to, text, graphics, images and other material contained in this discussion are for informational purposes only. The purpose of this discussion is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read in this blog.