TRIGGER POINT DRY NEEDLING (TDN) What is dry needling? History: Years ago when physicians were administering trigger point injections, they couldn't help but notice a "twitch" response when inserting the needle into the muscle. Other researchers became curious about this phenomenon and confirmed that the same response, and results, could be accomplished by using non-hollow and non-injectable thin filament needles for this new method called Trigger Point Dry Needling (TDN). TDN been used internationally for more than 40 years and was introduced in the United States in the late 90s. In August 2011, the Montana Board of Physical Therapy Examiners affirmed that TDN is within the scope of physical therapy practice in Montana. Physical therapists are now using this technique to effectively treat acute and chronic orthopedic and musculoskeletal conditions. How it works: TDN is an effective therapy to treat muscular tension and spasm which commonly accompanies conditions such as arthritis, nerve irritation, muscular strain, ligament strains, and herniated discs. With TDN the needle itself, and the resulting effects it produces within the tissue, is the treatment. When an injury occurs from repetitive use or acute trauma, inflammation will be produced from the damaged tissues. The damaged tissues will also go into a protective tension state or contracture to guard against further damage from continuing to use the injured tissue. This contracture and inflammation inhibit microcirculation which limits both the oxygen rich blood reaching the injury and the waste products leaving the injury. The injury site becomes hypoxic (decreased in oxygen) which stimulates the body to produce fibrosis or scar tissue. This fibrosis and scarring builds up around the muscles and tissues limiting the tissues ability to fully function (reducing range of motion) and can also cause compression and irritation of nerves (such as carpal tunnel syndrome) – all of which inevitably lead to poor function. TDN uses a sterile, single-use, solid filament needle which is inserted into this contracted, painful, and knotted muscle to create a local “twitch” response (LTR) which is both diagnostic and therapeutic as it is the first step in breaking the cycle which research shows will decrease muscle contraction, reduce chemical irritation, improve flexibility, and decrease pain. TDN Training received at New Horizons Physical Therapy Linda Looser, Physical Therapist, has received extensive training from the Myopain Seminars group, led by world-renowned authority on Trigger Point Dry Needling, Jan Dommerholt, from January through April of 2012 which covered instruction in TDN of the head, face, neck, trunk (including abdominal area), arms, legs, and pelvic floor. She has been using this technique with significant success on a consistent basis since that time. Is Trigger Point Dry Needling like Acupuncture? No. The only similarity is the tool that is used (solid, thin filament needles). Dry needling performed by trained physical therapists is based on Western medical research and principles including a thorough orthopedic evaluation and treatment plan designed to remove barriers to normal health and function by treating the neuromuscular system affecting muscle tightness, joint mobility, and symptoms of pain and irritation. Acupuncture is based on Traditional Chinese Medicine and includes the use of thin needles as one valuable part of their specialized practice which focuses on restoring energy to the body.
What are Some Conditions Treated with Dry Needling?
· Acute Pain · Chronic pain · Osteoarthritis · Muscle Strain · Sports injuries · Headaches/Occipital Neuralgia · Neck/Back Pain · Shoulder Pain · Tennis/Golfers Elbow · Carpal Tunnel · Abdominal Pain · Pelvic Pain · Hip and Gluteal Pain · Piriformis Syndrome · Sciatica · IT Band Syndrome · Knee Pain · Achilles Tendonitis
Does Dry Needling Hurt?
You may or may not feel the insertion of the needle. As the needle is manipulated to elicit a local twitch response (LTR), you may experience a very brief (less than a second) painful response often described as a “deep ache” or “cramping” sensation. You may also feel what is call “referred pain” as the trigger point “shoots” pain or sensation to other areas (from back to front, down the arm/leg, etc). The LTR response is what creates the desired therapeutic outcome.
What can I do to prepare for my Dry Needling session?
It is recommended that you eat a light meal 1-2 hours prior to your appointment and wear loose, comfortable clothing that can be rolled up or down to access your areas of concern with greatest ease. Also, drink LOTS of water both before and after your session to help flush your system.
What can I expect after my Dry Needling session?
You should notice instant improvements in range of motion, ease of movement, and decreased signs/symptoms. It is not uncommon to feel sore after the treatment in both the area treated and the associated referred pain pattern. Typically this soreness only lasts between a few hours to a couple of days. The soreness may be alleviated by applying ice or heat to the area and performing the specific stretches or exercises prescribed by your therapist.
How many treatments are typical to address my symptoms?
Every case is individual, but you should notice a marked decrease in your symptoms after only the first or second treatment. If your symptoms are caused by a repetitive mechanism which will continue due to the nature of your work or recreation, then methods will be discussed to reduce the repetitive nature of these tasks so your continued need for TDN will be minimalized. Acute cases from trauma or injury are often completely resolved in two to four sessions. Chronic cases may take longer as we will not only have to address the initial area of injury but the resulting protective nature of the body as the years add layer upon layer of tightened muscles and other trigger points.
What are the risks or precautions with TDN?
Extensive TDN training, coupled with a physical therapist’s vast knowledge of anatomy, emphasizes the reduction of injury or risk, but there are considerations. Because of the high risk of miscarriage from any event during the first trimester of pregnancy, TDN is not performed during that time. Lung puncture is a considered risk but with a highly trained therapist is of minimal concern. People on blood thinners can still be treated but with added precautions. If you have allergies to nickel then gold-plated needles will be used. Please inform your therapist if you have a breast, calf, buttocks, facial, or any other implant. Sterile, single-use needles are used to further reduce the risk of infection.