Let's talk about Dry Needling

 


Let's talk about Dry Needling

By Edward Era Barbacena



DRY NEEDLING IN PHYSICAL THERAPY:

Dry needling is a rapidly growing technique being utilized by physical therapists as a means to treat musculoskeletal pain and ailments by targeting connective tissue and myofascial trigger points. Physical therapists are utilizing this technique with immediate responses for pain relief and eliciting healing responses with subacute and chronic ailments.


WHAT IS IT?

Dry needling as defined by the APTA is a skilled intervention utilizing a thin filiform needle to stimulate a neural, muscular, connective tissues, and myofascial trigger points. (3) This technique has been utilized to address musculoskeletal ailments and facilitate healing and recovery. Dry needling is named as such due to the lack of utilizing a hollow tube with an injectable material such as corticosteroid or anesthetics. The needles utilized are most commonly known for their use in acupuncture. (1) Although dry needling may be similar in product utilization the goal and treatment philosophy differs slightly. Western medical approach is to target subcutaneous connective tissue as a means to release trigger points and stimulate improved blood flow at the muscular or tendinous level. Utilizing the biomedical model by placing needles in asymptomatic tissue proximal and distal to the pain generator as a treatment option to regain tissue homeostasis and facilitate the body’s natural healing process. Dry needling is supported in several studies for the treatment of tendinopathies by increasing blood flow through local vasodilation and collagen proliferation. (1)


HOW DOES IT WORK?

Dry needling utilizes three primary techniques:

1) Fast-in and Fast-out

Mechanical irritation with a filiform needle stimulates the nociceptors or the sensory loci, which likely elicits a twitch response in the musculature. With a twitch response a further strong neural impulse is sent to the trigger point circuit breaking the cycle and relieving the pain from the trigger point. Best response to the “fast-in and fast-out” mode of dry needling it to elicit a twitch response.

2) Needles left in situ

Optimum time frames for multiple needles left in the treatment areas tend to vary across studies between 10–30 minutes. For a variety of ailments such as cervical or lumbar pain it has been determined by a Cochran collaboration needle retention for 10 minutes or longer is better than the immediate removal following insertion. (2)



3) Needles utilized in muscle belly with electrical stimulation

Application of electrical stimulation (E-Stim) to the needles inserted to the muscle belly is known to help accelerate the pain relief process as well as stimulate further blood flow to the area.


WHEN TO USE IT:

Dry needling can be applied to individuals dealing with musculoskeletal ailments, tendinopathies, sports recovery, and to patients >3 months post op. It is suggested to have 48 hours between dry needling sessions and typically will see results immediately for muscular trigger point pain relief and within 2–3 sessions for more subacute and chronic ailments. Dry needling is utilized as an adjunct to physical therapy and sports training as a means to modulate pain and promote increased healing in the target tissue.

Important to note, not all physical therapists are certified to perform dry needling and availability to patients may vary state to state.

Contact your local Vista Physical Therapy clinic to see if they offer dry needling or inquire about any other musculoskeletal aches and pain.

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