Dry Needling

Myofascial Dry Needling

Dry needling is where a fine needle or acupuncture needle is inserted into the skin and muscle, usually focused towards a myofascial trigger point (some people call them ‘knots’) and its associated taught band (tight portion of muscle).

Myofascial trigger points are hypersensitive palpable nodules within skeletal muscle.  These often feel like a pea like nodules that are sore to touch and will often refer pain to distant parts of the body.  They are often associated with a taught band of muscle.  Trigger points can cause pain at the site, pain referred well away from the site (including many headaches), muscle weakness, poor muscle activation, reduced range of motion and even central sensitisation which is associated with chronic pain.

Techniques used for Myofascial Dry Needling

Repeated thrusting of the needle causing a local twitch response 

Dry-needling via repeated thrusting of the needle into myofascial trigger points can cause a local twitch response (this feels like a small involuntary contraction of the muscle that lasts an instant).   The twitch response is an involuntary spinal cord reflex contraction of the muscle fibres in a taut band. Triggering a twitch response has been shown to reduce the concentration of nociceptive substances (pain substances) in the chemical environment near myofascial trigger points, leading to an analgesic effect (decreased pain), increased range of motion and reduction or elimination of pain during movement.

A localised stretch to the connective tissues – twisting the needle

When twisting the needle there are a number of possible effects.  One proposition is that twisting the needle (which often causes an ‘ache’ about the area) ‘wraps’ some of the connective tissue about the needle causing a local stretch of that tissue.  This local stretch has numerous possible explanations for the relief felt post this technique.  These include local cell secretion of different chemicals, changes to the local matrix of tissue, changes to the pain signals along connective tissue planes and changes to the information that is sent to the spinal chord.

Muscle and other tissue regeneration – multiple needle use

Simply applying a needle, or many needles, may cause a small focal lesion which increases local blood supply,  triggers satellite cell migration to the area, increasing fibroblastic activity that creates repair or replacement of  damaged tissue.  This occurs 7-10 days after dry needling.

Pain reduction – single or multiple needle use

Single or multiple needle use, with or without thrusting or twisting, can cause a change in neurotransmitters (nerve chemicals) and nerve impulses (messages going to the spinal cord) changing your pain or discomfort.

What is Dry Needling used for?

Dry Needling has multiple uses:

• Referral Pain.  Referral pain is extremely common with trigger points. This can be pain shooting down your legs similar to sciatic pain, or pain into your shoulder, forearms or hands.
• Headaches from neck musculature trigger points.
• Stiffness.  Dry Needling has been shown to make positive changes to range of motion.
• Pain.  There are many circumstances when generalised pain (of all types) will be positively affected by Dry Needling.  The mechanism in which this occurs is still being debated but the clinical results are substantial.
• Injury recovery. Dry Needling is suggested to create a healing response in many forms of injury.  Again the mechanism is not fully understood.
• Tendon pain such as tennis elbow.  Dry needling creates a decrease in pain and also a healing response of local tissue.