Trigger Point Dry Needling

By: Michael Cyr, PT, DPT, CMTPT and Casey Porier, SPT


Straight to the Point: What is Trigger Point Dry Needling?

Most people are familiar with a painful muscle knot and most times these go away on their own. On occasion, however, they can become a chronic source of pain and effect muscle activation and function. Despite our body mass being 30% muscle there are no “muscle specialists” and these issues often go unmanaged. Myofascial pain (pain of the muscles and structures surrounding muscles) is the most commonly overlooked diagnosis in chronic pain patients (1).


Here’s what you need to know about dry needling as a potential treatment approach.

Figure 1.)


What is a trigger point?

A trigger point complex includes a contracture knot (area of contractured muscle fibers) within a tight or “taut” band of muscle (Figure 1). They can form from overuse, improper movement patterns or as a secondary effect of another injury or surgery. They can be found anywhere that there is skeletal muscle (jaw, neck, back, arms, legs etc.) and can cause local pain as well as referred pain outside of the immediate area the trigger point occupies (Figure 2).



Figure 2.)

How does Dry Needling work?

Dry needling utilizes sterile, monofilament needles to stimulate mechanical and biochemical changes in the trigger point to relax contractured muscle tissue and relieve pain.


How does dry needling fit into the traditional Physical Therapy model?

Dry needling is just one of many manual modalities used to decrease pain and improve muscle activation within a broader context of treatment. It should be used in adjunct to traditional interventions including therapeutic exercise and activity modifications to ensure the best long-term results.





Is this the same thing as acupuncture?

Trigger point dry needling is not acupuncture although some acupuncturists may be certified in dry needling techniques. Acupuncture is an eastern practice based on meridians, qi and the body’s flow of energy. Dry needling is a western practice adopted from injections and relies on muscle physiology and biochemistry.


Applications:

  • Primary soft tissue aggravation

  • Chronic Pain

  • TMJ (Temporomandibular Joint) pain

  • Post-surgical pain management

  • Impaired muscle activation sequencing

  • Pain management for sub-acute and chronic neurological impairments



If you think you or someone you know may benefit from this treatment modality call The Maine Strong Balance Centers at 207-303-0612 for an evaluation by one of our specially certified therapists.



Resources:

1) Hendler NH, Kozikowski JG. Overlooked physical diagnoses in chronic pain patients involved in litigation.

Psychosomatics. 1993 Nov-Dec;34(6):494-501. doi: 10.1016/S0033-3182(93)71823-X. PMID: 8284339.


2) https://encrypted-tbn0.gstatic.com/imagesq=tbn:ANd9GcQFR3UgeY7k7uXzJIGvvIH

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3) https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcSxubE1qlCwNCsQcxysRaEtEkYdrQLQV

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4) http://www.vasportsmedicine.com/images/content/dry-needling-1.jpg