Trigger Point Dry Needling
What is a trigger point?
A trigger point is a hyperirritable portion of muscle that results in taut bands within the muscle fiber. Essentially it’s a mini muscle spasm that can affect how you move and increase the pain that you experience. The pain can be either local (at the point of the trigger point) or it can radiate out away from the location of the trigger point.
What is dry needling?
Dry needling is an invasive procedure in which a solid filament needle is inserted into the skin and muscle directly at a myofascial trigger point. A myofascial trigger point consists of multiple contraction knots, which are related to the production and maintenance of the pain cycle.
Is dry needling similar to acupuncture?
There are many similarities and differences between dry needling and acupuncture. Licensed physical therapists in a growing number of states can use dry needling under the scope of their practice. Dry needling also falls within the scope of acupuncture practice. Physical therapists at Roberts and Associates Physical Therapy are not licensed acupuncturists and do not practice acupuncture. In contrast to most schools of acupuncture, dry needling is strictly based on Western medicine principles and research.
Are there additional charges for dry needling?
Many aspects of the dry needling treatment are covered by insurance, such as the identification of the hyper-irritable trigger point and any soft tissue work that may occur before or after treatment. This is covered as part of our use of manual therapy. There is a $5 per session supply charge to cover the cost of the needling supplies that is not covered by insurance. The supply charge does not apply if you are being seen for a workers compensation injury.
How does dry needling work?
The exact mechanisms of dry needling are not known. There are mechanical and biochemical effects. Based on the pioneering studies by Dr. Jay Shah and colleagues at the National Institutes of Health, we know that inserting a needle into trigger points can cause favorable biochemical changes, which assist in reducing pain. It is essential to elicit so-called local twitch responses, which are spinal cord reflexes. Getting local twitch responses with dry needling is the first step in breaking the pain cycle.
What type of problems can be treated with dry needling?
Dry needling can be used for a variety of musculoskeletal problems.
Dry needling can be used for a variety of musculoskeletal problems. Muscles are thought to be a primary contributing factor to the symptoms. Such conditions include, but are not limited to neck, back and shoulder pain, arm pain (tennis elbow, carpal tunnel, golfer’s elbow), headache to include migraines and tension-type headaches, jaw pain, buttock pain and leg pain (sciatica, hamstrings strains, calf tightness/spasms). The treatment of muscles has the greatest effect on reducing pain mechanisms in the nervous system.
Is the procedure painful?
Most patients do not feel the insertion of the needle. The local twitch response elicits a very brief (less than a second) painful response. Some patients describe this as a little electrical shock; others feel it more like a cramping sensation. Again, the therapeutic response occurs with the elicitation of local twitch responses and that is a good and desirable reaction.
Are the needles sterile?
Yes, we only use sterile disposable needles.
What side effects can I expect after the treatment?
Most patients report being sore after the procedure. The soreness is described as muscle soreness over the area treated and into the areas of referred symptoms. Typically, the soreness lasts between a few hours and two days.
What should I do after having the procedure done?
Our recommendations vary depending on the amount of soreness you have and on the individual response to the treatment. Recommendations may include applying heat or ice over the area, gentle stretches and modifications of activities.
How long does it take for the procedure to work?
Typically, it takes several visits for a positive reaction to take place. Again, we are trying to cause mechanical and biochemical changes without any pharmacological means. Therefore, we are looking for a cumulative response to achieve a certain threshold after which the pain cycle is disturbed.
Why is my doctor not familiar with dry needling?
In the US, dry needling is a relatively new method for treating myofascial pain and not everyone is already aware of this effective modality. Feel free to inform your doctor about this treatment option. It is upon all of us to educate others about new and innovative ways to treat pain.
Where does dry needling fit in the entire rehabilitation program?
Generally speaking, dry needling is the modality of choice when it comes to treating patients in the clinic. More frequently, dry needling is needed in the beginning in order to break the pain cycle. Once that is achieved, other treatment options 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 program combined with good posture can prevent many problems. If the pain comes back, “tune-ups” are recommended to treat and prevent serious injuries.
Can I do this at home?
No, this must be done by a trained healthcare professional due to the complexity of tissues involved, risk factors, and complications.