Tel: 01 283 4303Sticking a needle into a tender muscle may sound like madness but it often does help!
A very common condition we treat effectively with dry needling is pain and dysfunction within the muscle and connective tissue often centred around trigger points - a condition referred to as myofacial pain.
In this article I aim to describe why we use dry needling, how it works and the risks involved with some of the adverse reactions we may encounter.
What is myofascial pain?
This is a condition presenting as painful dysfunction within muscle and fascia (connective tissue) with the presence of hyperirritable trigger points thought to be the source of the pain.
These hyperirritable points in the muscles are acutely tender when palpated by the physiotherapist; they refer pain and may illicit a local twitch (flicker) response. Such a response in a muscle when palpated is abnormal. Trigger points develop when a muscle becomes overly shortened.
Dry needling / Medical Acupuncture
As Chartered Physiotherapists we aim to keep up with latest literature that reviews the efficacy of the treatment techniques we use in order to provide the best care to our patients. This article provides insight into the minimally invasive and effective technique of dry needling ( a form of medical acupuncture) for the treatment of myofascial pain.
Forming part of our integrated approach, every member of our team are specially trained in the medical acupuncture technique. Following careful assessment and diagnosis and after obtaining consent from the client, we will include dry needling as part of the every treatment if we feel it appropriate.
Why such a reliance on acupuncture?
Surely inserting a needle into a sore area seems counter-intuitive!
Dry Needling has been found to be effective, with evidence based research to support it, in the treatment of myofascial trigger points.
An acupuncture needle is directly and gently inserted into the trigger point which results in a variety of physiological changes within the muscle. This helps to reduce the tension and allow the muscle to relax, therefore relieving pain by ‘de-activating’ the trigger point.
There is some debate about whether deeper or more superficial needling brings about the best results. Edwards and Knowles (2003) carried out a study which found that superficial acupuncture showed a marked reduction in pain relief in comparison to stretching exercises. However other research has shown that deeper needling brings about longer lasting pain relief (Cecherelli et al, 2002).
We feel that deeper needling should be used with caution so as not to cause unnecessary discomfort for the client.
Are there any risks involved with Acupuncture?
Dry Needling is a safe form of treatment when used by qualified health care professionals. However, there are a small number of potential adverse reactions reported in the literature.
The most common are
- some pain after needling
- small amount of bleeding
- bruising
- temporary dizziness and sometimes fainting
The likelihood of these adverse effects occurring can be minimised with proper assessment and care in managing the ‘dose’ or ‘strength’ of treatment given by the physiotherapist.
A British based study in 2001 found no serious adverse reactions and 671 minor reactions in 10,000 acupuncture sessions such as those mentioned above.
Its benefits far outweigh the risk when carried out by a trained professional and we find it a very useful adjunct to manual therapy treatments and exercise therapy in the treatment of our patients.
References:
Kalichmas and Vulfson (2010) Dry Needling in the Management of Musculoskeletal Pain. JABFM September-October 2010. Vol 23
Edwards and Knowles (2003) Superficial Dry Needling and active stretching in the treatment of myofascial pain- a randomised controlled trial. Acpunct Med 2003; 21:80-6
White, Hayhoe, Hart Ernst (2001) Adverse events following acupuncture: prospective survey of 32000 consultations with doctors and physiotherapists. BMJ. 323:485-6
by Katie Gill.
