Australian Health Professionals
Both dry needling and cupping evolved from traditional Chinese medicine practices. Over the years, dry needling and cupping have gained enormous popularity amongst the sporting community, partially due to the unintentional marketing performed by high profile athletes displaying cupping marks at Olympic games.
Dry needling is used for musculoskeletal purposes only, whilst acupuncture claims to address other matters, such as anxiety. In dry needling, a needle is inserted into a tight area of the muscle. The aim is to elicit a ‘twitch response’ which is a quick involuntary contraction of the muscle. Following a twitch response, the muscle relaxes or ‘lets go’ of any tension and tightness. Yet, within the dry needling scope, there are different techniques and preferences amongst physiotherapists.
Some degree of pain or discomfort can be reported by clients during dry needling. In most cases, these are only mild. Safety protocols are also in place and form part of the compulsory training physiotherapists must undertake before practicing dry needling.
Cupping consists of using suction to mobilise soft tissue. Different from myofascial releases where pressure is applied to the body, cupping ‘lifts the skin’. Traditional cupping uses glass and fire to create the suction effect. It is also often applied under the premises of the traditional Chinese medicine principles. On the other hand, modern cupping may use plastic cups and suction pumps to create a similar effect. Some techniques involve leaving the cups stationary, whilst others combine the use of massage oil to slide the cups across the skin.
Claims such as improved local circulation and muscle relaxation are often reported.
Both dry needling and cupping evolved from traditional Chinese medicine practices.
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.
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.
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 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. Additionally, acupuncture needles are typically left in place for 15-30 minutes, whereas during dry needling the needles are typically left in for no longer than 15 minutes.
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.
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:
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.
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.