Medical Acupuncture & Dry Needling Now Available at PureBody Health Sports Injury Clinic
What is Dry Needling?
Dry Needling is utilised by a trained therapist to treat a vast number of myofascial and muscular injuries and complaints. Acupuncture needles are used to alleviate tight bands within an active muscle. A very fine single filament needle is inserted into the skin targeting muscle trigger points or knots. The needles used are so thin they typically cannot be felt as they break the skin and rarely cause bleeding. The use of needles as a form of treatment is an invasive procedure. However, it is very safe and is only carried out by qualified and trained therapists.
What are Trigger Points/Taught Bands?
Myofascial trigger points are an extremely common cause of pain often caused by overuse, increased stress,
poor posture or as a response to injury. Trigger points can be classified into two phases, active and latent.
The active phase of the trigger point is the one which produces intense pain symptoms often motivating people
to seek relief. We identify trigger points by the patient’s history and symptoms, pain pattern and by palpation.
Trigger points are painful when pressed or squeezed, they cause a shortening of the muscle fibres which can lead
to dysfunction, a characteristic called referred pain meaning that an active trigger point can refer pain in another
area of the body. Each trigger point has a specific referral pain that is reproduced when the trigger point
is activated by digital pressure or overuse.
A classic example of this is seen in the upper trapezes muscle. Many people complain about pain and tension
in the upper traps and neck area after a long day at work, or after a bout of housework or gardening etc.
Typically pain progression moves up the neck and into the base of their skull, in some cases it can cause
tension type headaches. The referral pattern for the upper traps are shown below in red with the
trigger points been shown by the marked X.
How do Trigger points occur?
- Repeated actions i.e. Housework/Work activities/Gardening.
- Sustained loading i.e. Gym work, Heavy lifting.
- Poor Posture.
- Tensing due to stress or depression.
- Inactivity and Sedentary lifestyles.
So, how does dry needling work and what does the science say?
Dry needling works by inserting the needle into the trigger point, which causes the muscle to grip onto the needle
in an attempt to resist the needle as a foreign body. This is called a localised twitch response or basically a large twitch.
This localised twitch response is necessary to deactivate the trigger point and to facilitate muscle relaxation.
This causes significant pain relief, decreased muscle tension and tightness as well as an increased range of motion.
A recent review of several studies found dry needling can be effective in providing immediate pain relief after treatment and at 4 weeks’ post treatment in patients with upper body muscle pain (Kietrys et al, 2013). There has not been enough research evidence to determine its effectiveness on lower body conditions. However, it is widely believed when performed correctly it will cause the same effect as it does in the upper body. The effectiveness of this treatment depends greatly on the skill of the therapist to accurately palpate myofascial trigger points as well as an extensive knowledge of the anatomical structures.
What am I going to feel?
Typically, one does not feel the needle go into the skin. However, once the trigger point has been located and a localised twitch has occurred, the type of sensation can differ from person to person. What is described mostly by patients is a strong muscle cramping once the twitch response has been elicited. Once you become accustomed to the sensation you will have no problem relaxing as deactivating trigger points are reducing symptoms, decreasing pain, restoring muscle length and improving function. After the treatment, there may be localised muscle pain similar to muscle pain associated with exercise induced muscle damage or DOMs. This tends to last no more than 24 hours.
Injuries & Benefits.
Dry needling is used for a wide variety of different injuries and conditions. It may be used once as part of your overall treatment plan or to help alleviate stubborn trigger points and tight bands of muscle.
Prior to treatment, your Sports Injury Clinic therapist will perform a thorough assessment to determine if you are a suitable candidate for the procedure. Dry needling will also be used with other forms of therapy, such as manual therapy, stretching, exercise or as part of your ongoing treatment plan. It can also be used on several occasions throughout your treatment for more chronic longstanding issues, these include but are not limited to the following:
- Trigger Point Release
- Postural Dysfunction
- Low Back Pain
- Aids in the treatment of Muscle Tears and Strains
- Shin Splints
- Planter Fasciitis
- Chronic Muscle Pain
- Rotator Cuff and Shoulder Pain
- Tension Type Headaches
- Tennis/Golfer Elbow
- Vast Number of Neck Issues/Whiplash
- Knee and Patellofemoral Pain Sciatica and Piriformis Syndrome
I have a medical condition or am taking medication… am I a good candidate to be needled?
There are a very few reasons that would cause you to be an unsuitable candidate for this treatment. Most patients can receive dry needling treatment as it is extremely safe. However, it is important to know therapists do not needle for the sake of it and needling is only one tool that is used as part of your treatment plan. Your PureBody Health therapist will be able to answer all questions and alleviate any concerns prior to this treatment.
The following lists are contraindications or where dry needling is not advised.
The relative contraindications are where caution needs to be taken but the treatment can
still be carried out safely, meaning dry needling will be conducted at the therapist’s discretion.
Absolute Contraindications (Dommerholt et al, 2013)
- In a patient with needle phobia.
- Patient unwilling – fear.
- Unable to give consent – communication, cognitive, age-related factors.
- Medical emergency or acute medical condition.
- Over an area or limb with lymphedema (risk of infection)
- Inappropriate for any other reason.
Relative Contraindications (Dommerholt et al, 2013)
- Abnormal bleeding tendency
- Compromised immune system
- Vascular disease
- Frail patients
- Patients with epilepsy
- Psychological issues
- Patient allergies
- Patient medication
- Unsuitable patient for any reason
Dry Needling is an excellent tool that is utilised in conjunction with other treatments to get you back to full fitness
and health. In most cases, it is a faster way to relieve trigger point type pain over the traditional trigger
point pressure massage.
Your therapist will assess you to determine if you are a good candidate for the treatment.
Please contact Gavin at PureBody Health Sport’s Injury Clinic on
01371 859991 or firstname.lastname@example.org
- Ana Mendigutia-Gómez, PT, PhD, Carolina Martín-Hernández, PT, Jaime Salom-Moreno, PT, PhD, César Fernández-de-las-Peñas, PT, PhD. Effect of Dry Needling on Spasticity, Shoulder Range of Motion, and Pressure Pain Sensitivity in Patients With Stroke: A Crossover Study
- Dommerholt J., Fernandez-de-las-Penas C. Trigger Point Dry Needling. An Evidenced and Clinical-Based Approach. Edinburgh: Churchill Livingstone-Elsevier, 2013
- Furlan AD, van Tulder MW, Cherkin D, Tsukayama H, Lao L, Koes BW, Berman BM. Acupuncture and dry-needling for low back pain. Cochrane Database of Systematic Reviews 2005, Issue 1.
Kietrys, D. M., Palombora, K. M., Azzaretto, E., Hubler, R., Schaller, B., Schlussel, J. M., & Tucker, M. (2013). Effectiveness of dry needling for upper-quarter myofascial pain : a systematic review and meta-analysis. Journal of Orthopaedic Sports & Physical Therapy, 43 (9), 620634