Dry needling has evolved from traditional Chinese medicine practices and is performed by physical therapists to provide pain relief. Dry needling involves the use of sterile needles (also known as acupuncture needles), and targets musculoskeletal pain such as muscle soreness and muscle tension and increases blood flow. It is often associated with western medical acupuncture. Dry needling has become an increasingly popular form of treatment for myofascial trigger points amongst elite athletes, or simply those prone to chronic pain. Trigger point dry needling is often incorporated into a broader physical therapy routine, in conjunction with other physical therapy treatments such as joint mobilisation and massage.
This blog post will answer common questions about dry needling, including:
- What is the difference between dry needling and acupuncture?
- What are myofascial trigger points?
- What causes a trigger point?
- How does dry needling help trigger points?
- Is dry needling safe?
- How to get the most from dry needling?
What is the difference between dry needling and acupuncture?
Acupuncture and dry needling are both forms of needling therapies, and involve the insertion of thin, sterile needles into specific locations across the skin to trigger particular responses. The main differences between dry needling and acupuncture are the technique and theory for how and where the needles are placed.
Dry needling is focused on using strong stimulation of trigger points in order to reduce muscle tension. In contrast to this, western anatomical acupuncture is based on channel theory and does not use strong stimulation, but rather uses trigger points to heal the body and muscle naturally. A physical therapist will use dry needling to relieve pain and tension from knots and pressure points in muscle tissue, whereas practitioners of acupuncture insert needles to release endorphins and affect the central nervous system.
In addition to this, the patient process also differs between the two practices. Acupuncture needles are typically left in place for 15-30 minutes, with an acupuncturist performing the treatment. An acupuncturist is a certified health professional who applies traditional Chinese medicine in the form of acupuncture.
During dry needling, however, needles will be placed deeply or superficially depending on which area of the body is being treated. They are typically left in for no longer than 15 minutes, with the occasional manipulation or winding of the needle. Dry needling is most often performed by physical therapists or sports injury specialists, who are trained and correctly certified in the treatment for myofascial trigger points.
What are myofascial trigger points?
Myofascial trigger points, also known as trigger points, are muscle knots. They are sensitive spots in the skeletal muscle that can cause deep pain. A trigger point is a hypersensitive palpable nodule that develops in the taut bands of muscle, referred to as the fascia. When pressure is applied to these areas, there will be pain in an alternate part of the body. This is known as referred pain.
Referred pain is pain perceived at a location other than the site of the painful trigger point. It is the result of a network of interconnecting sensory nerves and connective tissue. In the majority of cases, referred pains will occur outwards from the centre of the body. For example, the lower back can refer pain to the legs, or the hip can trigger knee pain. The most common causes of this are muscular pain radiating from the spinal cord, joints, tumours, or associated manipulations. This autonomic phenomenon is due to the multiple sensitive nociceptors located in the region of each trigger point.
What causes a trigger point?
Specific causes of trigger points can include, but are not limited to, overuse, trauma, repetitive straining, or alignment imbalances. An acute muscle injury can also lead to the development of trigger points. Post-injury or overuse, sensitive areas of tight muscle fibers can begin to form in the muscles. These sensitive areas are referred to as active trigger points.
Active trigger points are characterised through extreme tenderness located within the skeletal muscle and can result in significant muscle pain. Physical therapists will often use intramuscular stimulation or trigger point dry needling technique to release or lengthen muscles that may be causing chronic muscular pain.
How does dry needling help trigger points?
Dry needling theory suggests that the use of a thin, sterile needle to penetrate the skin and stimulate underlying muscular and connective tissue can assist in the management of musculoskeletal pain and movement impairments. The effectiveness of this treatment option is often characterised through a physical reaction known as local twitch response.
A local twitch response is a brief contraction of a taut band of skeletal muscle fibers, triggered by snapping palpation of a trigger point in that band. In a clinical context, the local twitch response is a valuable sign that indicates the presence of a myofascial trigger point.
Dry needling for musculoskeletal conditions and acute or chronic pain relief targets triggers points that develop within tense muscle. During trigger point dry needling treatment, the needle stimulates muscle to provide pain relief. This stimulation encourages the muscle to return to its normal mobility, only with less pain.
Is dry needling safe?
Although dry needling is an invasive procedure, it is a safe treatment option for a range of musculoskeletal conditions. The manual therapy offers minimal discomfort for patients and is performed by a trained professional who is certified in the procedure.
When performed by a trained professional dry needling is safe, however, like all other treatments there are minimal associated side effects. According to Healthline, mild side effects can be common with dry needling, and serious side effects are rare.
Mild side effects often occur around the injection site, 24 -48 hours after a dry needling session and can include:
- Bruising
- Bleeding
- Temporary soreness.
These mild side effects will typically resolve on their own, however gentle activity such as stretching of the area, or a gentle massage may provide relief.
How to get the most from dry needling?
Dry needling offers maximal benefits when incorporated into a treatment plan. A physiotherapist may conduct an initial assessment to review the treatment options for your unique circumstance.
It is important to consult with a physiotherapist about your injury. Call one of our professionals today on 1800 491 697 or visit our booking portal to find a local AHP Physio clinic near you.
