Dry Needling

Causes of Trigger Points

There is a general agreement that the most common reason for the development of trigger points are muscle overload, such as sustained low level muscular contractions or direct trauma.

Trigger points may develop during sport, occupational or recreational activities when a muscles capacity to adequately recover is exceeded.

Common Treatable Conditions

• Low back pain

• Hip pain

• Neck pain

• Headaches

• Jaw pain (TMJ)

• Shoulder conditions

• Tennis elbow

• Knee pain

• Dry needling techniques may also be used to target joints, fascia, tendons, scar tissue and sports injuries.

Acupuncture and Dry Needling

These two treatment terms are often confused and used interchangeably. Acupuncture is firmly based in Traditional Chinese Medicine (TCM), whereas Dry Needling is based on a Western Biomedical model.

Dry needling requires extensive training and practice including a firm knowledge of anatomy in order to develop the sensitivity and appreciate subtle changes in tissue compliance to find and deactivate trigger points.

Research

There is a large body of research on the effects of dry needling. Level 1 evidence suggests that dry needling is more effective than sham or placebo for a large range of musculoskeletal conditions.

Peripheral Sensitization

The local reduction in the pain threshold with an increase of responsiveness by peripheral pain fibers (nociceptors) is termed as peripheral sensitization.

Myofascial trigger points are not merely a peripheral phenomenon, nociceptive input from MTP’s leads to effective segmental sensitization and hyper-excitability of dorsal horn neurons in the spinal cord (Mense 2010)
Researchers (Hong et al 1996) found that pressure sensitivity is higher in the Trigger Point site than at other control points in the muscle.

Findings revealed a local concentration of bio-chemicals that increase pain sensitivity such as (substance P, CGRP, Tumor necrosis factor, Interleukins 6 & 8, 5-HT and nor-epinephrine), these were all higher in the MTP’s zone compared to control points (Shah et al 2005). 

These pain-producing chemicals may be released from the locally sensitized nerve fibers (nociceptors) but also from the muscle contraction within the tight band (Gerwin 2008).

Local Twitch Response (LTR)

When a clinician strums across active muscle fibers and it responds with a sudden reflex contraction, it is called a Local twitch response.
The LTR has been correlated with the degree of sensitization within the muscle.
Eliciting an LTR with needling has shown to have a positive therapeutic effect in releasing the local tension and downgrading the concentration of pain producing chemicals.