At the mere mention of needles, many people become nervous and apprehensive. Some go so far as to associate them with pain and discomfort and prefer not to have any form of needling done in their treatment sessions. This is puzzling to me as, often, their reason for visiting a specialist is to deal with the presence of existing pain and discomfort. To the credit of this therapeutic technique, any discomfort felt will be momentary and overshadowed by the long term benefits of Dry Needling in easing muscle pain.
The needle is the most effective instrument available to therapists to stimulate the Peripheral Nervous System through muscle receptors. It is also an effective means through which to release Myofascial trigger points – physio speak referring to a hyperirritable spot normally within a taut band of muscle.
Trigger points may:
- Refer pain
- Alter sensation
- Affect joint and muscle range of movement
- Cause muscle weakness
(See previous articles for more information on trigger points).
Furthermore, many patients confuse Dry needling and Acupuncture. Even though the needles are the same and 71% of Myofascial trigger points overlap with classical acupuncture points (Melzack), the premise of each technique is very different. Unlike Dry Needling, Acupuncture is a branch of Chinese medicine in which the needles are used to target specific points that provide access to the meridians in the body through which Qi (energy) flows. Acupuncture aims to balance the energy.
Dry Needling offers both Superficial and Deep needling:
Superficial Dry needling involves the use of short, narrow needles placed into the tissue directly over the trigger point or painful area. The pin prick stimulates so-called A delta fibers which are faster than the fibers which carry the pain stimulus (C fibers). The stimulation of the A delta Fibers therefore reaches pain receptors first with the effect of assisting to block out pain (see diagram below). In fact, similar pathways are involved in the way in which rubbing a sore toe that’s been bumped can help to ease that pain.
Deep Dry needling sees a needle placed directly into the trigger point. Thus much longer needles are used to reach the trigger points in the muscles. Insertion of the needle in this way triggers a host of physiological responses which ultimately see the release of the myofascial trigger point. What one could expect to feel during needling is a deep muscle ache, referred pain or a local twitch response when the muscle being needled jumps or twitches as the trigger point is accessed. Patients are often concerned when this happens but specialists will reassure them that this response is a critical element of successful therapy and is in fact encouraged.
After undergoing needling it is very important that one stretches the muscles that have been needled and applying heat can ease any stiffness.
Needling is not to be seen as an isolated treatment. It is one of many techniques available to a physiotherapist in treating a patient holistically and effectively. It is my hope that this information will go some way towards removing the fear associated with the therapeutic tool that is Dry Needling.
BY: Andrew Savvides
Back injuries, General Health/Fitness