Trigger point Dry Needling

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What is Dry Needling?

Trigger Point Dry needling is a technique used to treat tight and painful muscles. This can improve blood flow, increase motion and help reset the neuromuscular pain response.

A very thin, sterile needle, like what is used in Chinese Acupuncture, is inserted into the muscle belly to get the muscle to contract and "Twitch". This then releases the muscle contraction and can restore the normal blood flow, return the area's pH to normal and the muscle fiber can then contract and relax like a normal muscle again.  This can also help as a nervous system "Reset" from a chronic pain response.

What makes a trigger point painful? 

When a muscle is in a sustained contraction, the pH becomes very acidic and this can cause inflammation and pain.  The spinal cord and sensory areas of the brain can begin picking up too many signals and normally non-painful pressure becomes tender and sensitive. This can strain the neighboring structures and can create more trigger points as the muscle becomes less and less efficient. 

How does this impact motion?

If a muscle is taut and banded, it is difficult to stretch. Sometimes if the muscle is deep, it can be even hard to massage back to normal. Tight muscles can impair joint movement. We commonly see this with ankle, knee and hip pain.  "Frozen shoulder" symptoms can commonly improve rapidly by treating the local trigger points restricting the normal movement of the scapula and arm. 

How does dry needling change the nervous system's response to pain?

If you have ever had a tension headache, you can probably remember the sensitivity to loud noises. The noise may be tolerable on any other day, but with a headache, it feels like a booming throb inside your head.  When muscles compress the superficial or deeper nerves, the nerves can become very sensitive. Actually, trigger point dry needling is a great adjunct for headache management along with Botox injections (Which would be a "wet' needle injecting liquid medication into the trigger points) .  

What to expect on your visit?

Each muscle takes 1-2 minutes to treat. The needle is inserted and moved slowly until the muscle relaxes. Most people find very little discomfort, rating a 2 out of 10 with normal or slightly impaired muscle. An active trigger point can give a strong, sharp "Twitch" which is a good sign.  Sometimes the sensation can refer to another part of the body. Discomfort is usually fleeting and the immediate response is a relaxed, less painful muscle. If the muscle is significantly impaired or a lot of muscles are done at the same time, there can be some soreness which typically is better within a day. 

Are there any risks?

Please let the physical therapist know if you are on any blood thinners. Certain muscles are avoided and sometimes there is a little bruising afterward. 

Dry needling cannot be done through any implants, such as breast and buttock enhancements.

Impaired lymphatic systems such as lymphedema may limit areas of dry needling. 

It is not recommended to go swimming for 48 hours after dry needling. Like any break in the skin, exposure to dirty water and high areas of bacteria should be limited. Normal bathing is perfectly fine.

The physical therapist has highly specialized training and knows the areas that should be avoided due to arteries and nerves. There are techniques to minimize risk around the chest area and before any treatment of high risk areas, you will have a detailed conversation with the therapist to help decide the treatment approach.

The most common side effects to dry needling is slight bruising, bleeding or temporary soreness.

How many visits should I expect until I feel better?

Many times, you will feel immediate results in the first visit. Sometimes if the trigger points are from an old injury and there is no reason for the muscle to tighten again, one treatment is all that is needed. Mutiple trigger points over many body areas can take 5-6 visits, each providing almost an additive amount of relief! If the problem continues to return in the same muscle, the therapist will work with you to help figure out what the underlying cause is to help fully resolve the problem if possible. Some conditions like Fibromyalgia are chronic and trigger point dry needling  can be used routinely to help maintain function.