Physiotherapists use various treatment techniques to relax muscle spasm, improve muscle flexibility and ultimately decrease pain.
Over the years, dry needling has proven to be an effective tool when used either alone or in combination with other physiotherapy treatment to aid muscle recovery in both acute and chronic conditions.
What is dry Needling?
Dry needling is a technique which uses fine, sterile needles that are inserted into tender areas of muscle called trigger points.
This facilitates the restoration of normal muscle length with a corresponding decrease in pain, therefore promoting healthy muscle function.
What is a Trigger point?
Trigger points are simply localized knots or nodules found within taut bands of muscle that are often irritable and painful to touch.
These nodules occur as a result of a muscle being overactive and remaining in shortened state of tension, instead of returning back to its normal, relaxed lengthened position (Lavelle et al., 2007).
Taut bands are thought to arise from local injury to muscles. Over time this can cause pain within the affected area that affects normal muscle function (Bennett, 2007).
Research shows that a high percentage of patients who present with muscular pain are often found to have trigger points which, when palpated cause pain and discomfort that accurately reflects their symptoms.(Kalichman and Vulfsons, 2010).
Photo credit – Central Performance
What factors can produce trigger points?
Various factors may lead to the development of trigger points
Injury, resulting in muscle tightening as a protective body response
Unexpected or quick movements that result in poor muscle control
Increasing our activity, resulting in overloading of our muscles
Sustained posture that causes muscles to shorten and tighten
Overloading our body due to increased stress, illness and/or nutritional deficiencies (Simons et al., 1999).
An appropriate size needle is selected and inserted into a muscle, with the aim of producing a twitch response or, of reproducing the patient’s symptoms.
This is achieved by inserting a needle at an appropriate depth and if need be, gently stimulating the needle. Patients may feel a slight prick or stinging sensation prior to experiencing a twitch or dull ache.
This is a perfectly normal response and tells us that we have correctly positioned the needle into the trigger point of the affected muscle.
As the muscles relax, the patient usually reports that their symptoms are easing, after which, the needle is safely removed.
Photo Credit – Physioworks
How does Dry Needling work?
Dry needling aids muscle recovery by relaxing trigger points. This allows our muscle fibers to naturally lengthen and shorten properly as we participate in physical activity.
Furthermore, by improving blood supply to the affected area, our muscles are supplied with important nutrients that promote healing while flushing away pain producing chemicals.
The overall effect is a relaxation of tight muscles. This in turn results in a decrease in pain and improvement in the irritability of trigger points, promoting normal muscle function and therefore muscle recovery. (Mason et al., 2014).
BENNETT, R. 2007. Myofascial pain syndromes and their evaluation. Best Pract Res Clin Rheumatol, 21, 427-45.
KALICHMAN, L. & VULFSONS, S. 2010. Dry needling in the management of musculoskeletal pain. J Am Board Fam Med, 23, 640-6.
LAVELLE, E. D., LAVELLE, W. & SMITH, H. S. 2007. Myofascial trigger points. Med Clin North Am, 91, 229-39.
MASON, J. S., TANSEY, K. A. & WESTRICK, R. B. 2014. Treatment of subacute posterior knee pain in an adolescent ballet dancer utilizing trigger point dry needling: a case report. International journal of sports physical therapy, 9, 116-124.
SIMONS, D. G., TRAVELL, J. G. & SIMONS, L. S. 1999. Travell & Simons’ myofascial pain and dysfunction: upper half of body, Lippincott williams & wilkins.