Trigger Point Dry Needling- What You Should Know
Trigger Point Dry Needling (TDN) is a physical therapy intervention involving a thin filament, similar to an acupuncture needle, that is inserted through the skin targeting myofascial trigger points in the underlying tissue. The term “dry” needling refers to the use of the needle in and of itself, as no medication is used in conjunction with the procedure. Other terms often used to describe the same technique are “intramuscular dry needling” and “intramuscular manual therapy”.
Is This the Same as Acupuncture?
These techniques are often confused with acupuncture; however, the only similarity is the use of a filament needle that is used to penetrate the skin. Acupuncture is based on Traditional Chinese Medicine and stimulates acupuncture points along energy lines called meridians. The thought is to restore “energetic Chi balance” to treat disease. Dry needling is based on Western medicine scientific principles and a plethora of research. TDN treats pain associated with trigger points causing muscular pain that can often radiate to various parts of the body depending on the location of the trigger point.
What is a Trigger Point?
Trigger points are “knots” within a taught band of skeletal muscle that is often reactive, tender and irritable when pressure is applied to that area. If the trigger point is chronic, it may or may not be tender to touch and then is called a “latent” trigger point. Trigger points will often refer pain to nearby body regions, particularly if the trigger point is creating dysfunction with daily living.
Why Dry Needling?
Often, when dysfunction occurs and it is deemed that it is muscular in nature, many of the muscles responsible for this dysfunction are deep muscles that are difficult to resolve with manual techniques, solely due to position of that muscle. Chronic muscle pain can also be difficult to resolve with manual soft tissue work alone, as the trigger points have likely been present for a substantial amount of time. For this reason, dry needling can often speed up your rate of recovery, and improvements in function are common immediately following the procedure. Despite this, dry needling is only a portion of the entire treatment plan, and manual techniques to restore motion and therapeutic exercises to address stability and function around that region should be incorporated into the treatment for optimal outcomes.
What To Expect During the Procedure
Typically, the needle is inserted for a period of 5-10 seconds and then promptly removed. There are instances when the needle would be inserted for a longer period of time, however, your therapist will talk with you about this prior to the procedure. The filament or needle used is very fine, and therefore, the patient may or may not feel the insertion of the needle. It is common to feel discomfort or some degree of pain when the needle penetrates the trigger point, and this discomfort can radiate to other body parts that are associated with the dysfunction, however, this typically subsides once the needle is removed.
Are There Risks and Side Effects?
It is not uncommon to feel soreness following the procedure due to a release of chemicals that occurs when the trigger point releases. This soreness often feels like you may have completed a workout, and can feel very fatigued. Serious side effects are very rare, and are preventable with sterile needle techniques and careful technique during the procedure. The two major risks are a puncture to the lung and infection. To avoid a lung puncture, only short needles are used throughout the thorax and specific procedures are used to angle the needle away from the lung fields.
The second major risk is infection. In order to guard against infection, the clinician wears gloves and uses sterile single use needles. Infection risk is extremely low and not a concern unless the patient is dealing with an active infection at the time of treatment.
Mild risks include bruising at the puncture site, and very small amounts of bleeding are common. Applying pressure to the puncture site immediately following the procedure can minimize bruising and bleeding.
Common Conditions that Can Be Treated With Dry Needling
• Neck and shoulder pain
• Low back pain
• Plantar fasciitis and foot pain
• Achilles tendonitis/tendinosis
• Tennis/Golfers elbow
• Hip pain/Snapping Hip Syndrome
• General knee pain
• Improve ROM restrictions due to muscle spasms