How does dry needling work to release an MTP?
The fine filament needle is inserted into the muscle to directly target the MTP. This allows fresh blood supply to pool around the trigger point providing the muscle with the necessary inputs it has been lacking (oxygen and nutrients) and allows the byproducts (acidic chemicals) to be transported away. As a result of this process, the muscle fibres relax and lengthen back to their normal resting state, this decompresses local blood and nerve supply, which initiates the physical relief that patients feel.
What is the Difference Between Dry Needling & Acupuncture?
This is a common question. Dry Needling and Acupuncture are similar in that both techniques use the same needles, however their clinical reasoning, theory and application is very different.
Dry needling is a modern medicine technique with supporting research that shows a local neuromuscular reaction occurs in the muscle when a trigger point is stimulated, resulting in a muscle release. In physiotherapy, dry needling is used for the release of myofascial trigger points to improve muscle function and reduce pain.
For each muscle in the body, there are common trigger point locations that are prone to developing trigger points when put under excess load. Physiotherapists use this as a guide when releasing muscles with dry needling.
Acupuncture, on the other hand, is derived from Chinese medicine and is a healing therapy that is based on the theory that the human body is made up of many energy pathways, which, when stimulated at specific points, can release energy blockages and restore the flow of energy and balance.
What is a Myofascial Trigger Point? (MTP)
A myofascial trigger point is commonly referred to as a muscle knot. This is a group of shortened muscle fibres that have not lengthened back to their normal, relaxed state after being used or loaded. A trigger point is characterised by a sensitive nodule in the muscle that occurs when the muscle fibre becomes shortened and tight, to the point that there is compression of the capillaries and nerves that supply them. The muscle, therefore, doesn't get the blood supply it needs to receive its inputs to function (oxygen and nutrients) and it can't get rid of its by-products (additional acid chemicals). As a flow-on effect, the rest of the muscle fibres around this point then tighten to compensate. This leads to discomfort during touch, movement and stretching, and overall restricted physical movement.
What causes Myofascial Trigger Points to form?
MTPs are formed in muscle as part of the body's automated protective mechanism to protect itself from harm. Here are some of the reasons you may develop an MTP:
A muscle will tighten into a trigger point to protect the body from further injury
A result of quick, or unexpected movement
A sudden change in activity type or training load
Sustained postures/load e.g. prolonged sitting
Nerve inflammation, irritation or impingement will cause the muscle to tighten into a trigger point to protect the nerve
Illness - bacterial or viral
Nutritional deficiencies, metabolic and endocrine conditions
(Simons, et al., 1999)
What is Dry Needling?
Dry needling is the use of a sterile, fine filament needle that is inserted into the muscle to release a myofascial trigger point (otherwise referred to as a muscle knot) thereby relieving pain and muscle tension. These needles are very fine and don't inject fluid into the body, hence the name "dry" needling. This technique is a great way to release trigger points, especially those deep in the muscle belly.
Quick and effective, dry needling provides minimal disruption to the surrounding muscle tissue and can be particularly useful for people who find massage techniques aggravate their symptoms.
Although people who haven't experienced dry needling before often believe it to be a daunting treatment modality, it is, in fact minimally invasive, reduces discomfort and produces a near-instant, lasting relief.
What will a feel when I get dry needling?
Dry needling results in minimal discomfort, similar to a pin-prick. Patients may feel sensations and muscle movement as the muscles respond. It is normal for there to be a local "twitch response" (muscle fasciculation) or body twitch (whole-body movement) when the dry needle reaches the MTP. In fact, eliciting either a twitch response or reproduction of the pain is a good indication that the MTP has been released correctly.
How will I feel after having dry needling?
It is normal to experience any of the following symptoms after having dry needling treatment:
Achy muscle (in the few hours post-treatment)
The following day you may continue to feel achy, similar to muscle soreness felt after doing a workout
Feeling of general fatigue - It is recommended to drink lots of water after treatment to help minimise this feeling
Do all Physiotherapists practice dry needling?
Dry Needling is a postgraduate specialty course outside of the physiotherapy curriculum and is therefore not offered by all practitioners. Physiotherapists undergo specific training in this area and receive their qualifications prior to being permitted to utilise the technique in their treatment procedures.
Emily Gray has completed the postgraduate course and specialises in this treatment.