To the Point – Dry Needling
Dry needling is an advanced technique used by physical and occupational therapists at Hand to Shoulder Center of Wisconsin for treatment of pain and movement impairments. It’s a skilled procedure that involves using a sterile, thin filiform needle to penetrate the skin, targeting the myofascial trigger points, which are taut bands of skeletal muscles located within a larger muscle group. No medication is injected through dry needling, hence the name, “Dry Needling”. It is also referred to as trigger point dry needling (TDN) or myofascial trigger point dry needling. It is not acupuncture.
The goal of dry needling is to release or inactivate the trigger points, which helps to relieve pain and increase range of motion by reducing muscle tension.
When an injury occurs, inflammation develops in the damaged tissues, causing the tissues to go into a protective tension state which guards against further damage. This protective tension state limits both the oxygen rich blood from reaching the injury and the waste products from leaving the injury site. The site becomes hypoxic (decreased in oxygen), causing the body to produce fibroblast cells that produce fibrosis or scar tissue. When the fibrosis or scar tissue builds up around the tissues and muscles, it limits range of motion, causing compression and irritation to the nerves which affects the overall ability of the muscle function.
When addressing myofascial trigger points, one needle is utilized at a time. Pistoning and coning techniques are used around the trigger points, which often result in local twitch responses. Twitch responses are the first steps to breaking the pain cycle as it decreases muscle contraction, improves flexibility and reduces chemical irritation, therefore relaxing the taut band.
Dry needling for scar tissue uses multiple needles that are placed superficially along the scar. A rotation technique is used which increases tension, resulting in the change of shape and breakdown of the scar tissue. The needles are left in place until tissue relaxation has been achieved. The needles are then easily removed.
Dry needling can be done on many areas of the body. At Hand to Shoulder Center, our therapists often apply dry needling in conjunction with manual physical and occupational therapy for conditions such as shoulder or arm pain, tennis elbow, tendonitis, carpal tunnel, golfer’s elbow and scars.
Most patients are good candidates for dry needling; however, precautions must be taken for individuals with such conditions as anxiety, needle phobia, open wounds, metal allergies, pregnancy, bleeding disorders and others.
The risk factor is minimal; muscle soreness, minor bleeding and bruising may occur. Ice, heat and gentle stretching help reduce these symptoms.
In addition, your therapist may recommend that you:
- Drink plenty of water to stay hydrated to help muscles heal.
- Exercise and stretch as long as your pain does not return when you are doing these activities.
- Gently massage your muscles to stimulate the tissues to help resolve the soreness and pain.
We have qualified therapists at Hand to Shoulder Center who are uniquely trained and certified in dry needling. It is one of the many tools in their toolboxes to aid in the rehabilitation process. To schedule an appointment with one of our expert therapists to identify your trigger points that continue to be painful, call our clinic today to determine if dry needling is appropriate for you!
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