If you have chronic pain, chances are, you’ve tried a few techniques to feel easier in your body.
In the World of musculoskeletal therapy, one intriguing technique gaining attention is Trigger-Point Dry Needling.
This method involves inserting fine needles (0.25 mm) into specific areas of the skin and muscle, targeting trigger points. These trigger points are hyperirritable spots found within taut bands of skeletal muscles, often felt as “knots” or “nodules”.
If you know me, you’ll know I LOVE trigger point therapy…but what even is a trigger point? And why do we need to ease them in order to feel better? Lets take a look, so we can see how dry needles can help:
Understanding Trigger Points
Types of Trigger Points:
- Primary Trigger Points: They can spontaneously cause local or referred pain, muscle weakness, and/or restricted range of motion.
- Secondary Trigger Points: These do not cause pain unless stimulated but may impact muscle activation patterns and contribute to restricted movement.
Formation of Trigger Points:
- Trigger points are believed to arise from an excessive release of acetylcholine.
- A taut band forms within muscles due to the increased release of acetylcholine.
- Sustained taut bands contribute to persistent pain.
- There is an inhibition of the calcium pump in the muscles, which is why you can sometimes feel the ‘knot’, as well as the shortening of the fibres.
What happens with trigger points once they’ve developed?
- Trigger points lead to decreased blood flow, causing hypoxia and decreased pH within the muscle, activating muscle nociceptors.
- This process results in peripheral sensitization, contributing to pain.
- Central sensitization is also associated with trigger points, where there is feedback forward and back through the nerves to the brain, which is where we percieve our pain from. (This is a huge factor in long-term chronic pain)
Now we know what a trigger point is, how could dry needling help?
- Dry needling is a western form of acupuncture, using the same needle, but using it for application into a trigger point, rather than using the traditional chinese medicine of meridians.
- It requires inserting the needle beyond subcutaneous tissue into the muscle, reaching myofascial trigger points.
Would you like to see what a dry needle/acupuncture needle is like?
How does it work?
1. It produces a “Local Twitch Response”:
- Dry needling elicits a ‘local twitch response,’ causing a small contraction of the muscle.
- This response alters muscle fiber length and tension, stimulating relaxation.
2. Effects on Blood Flow:
- Sustained contraction in trigger points may cause local pain and lack of oxygen flushing through that area.
- Dry needling induces ‘vasodilation’ – which is, an increase in blood flow and oxygenation in the affected muscle.
3. Neurophysiological Effects:
- Dry needling triggers local and central nervous responses (this is muscle to brain communication) to restore homeostasis, reducing central (brains perception) and peripheral sensitization to pain.
- Through research, we know that dry needling stimulates the relaxing hormones like seretonin. This creates the feeling of relaxation too after treatment as well as pain reduction.
Who can have dry-needling?
Trigger-point dry needling is indicated for various conditions, including:
- Myofascial pain with trigger points
- Strains
- Osteoarthritis
- Tendinopathies
How will I be using it in my treatments going forwards?
My application of dry needling will be within the massage session, where I find the trigger point, and dry needle that muscle. I will then leave it to respond, whilst I work on another area of the body. When I take the needle out, I will be palpating to check the trigger has disipated.
Conclusion
In conclusion, trigger-point dry needling is an invasive and effective procedure for managing musculoskeletal conditions. By targeting myofascial trigger points, it aims to alleviate pain, improve range of motion, and enhance overall function.
Of course I have been dry needling Dan already, and this is his range of movement in the piriformis after 10 minutes! What do you think? Is dry needling on your agenda for your next treatment?
