What is a Point Stimulator?
The point stimulator is similar in appearance to a large pen, it is a handheld device. The model we use in the clinic is the Pointer Excell 11 which we have found to be very effective and reliable.
The tip of the point stimulator, similar to the tip of the pen, sends a gentle current through the needle and into the muscle. This may enhance the sensory effects of dry needling which promote blood flow, healing and have local analgesic effects. The point stimulator also causes small micro-contractions within the muscle which may have additional mechanical effects as well as allowing accurate confirmation that the correct muscle is being needled.
Benefits of using the point stimulator are:
It can be used to ensure that the needle is inserted into the correct muscle so it is useful as a diagnostic tool.
It can also be used as a treatment tool by directly stimulating the needle for 2-10 second bursts with a 5 second rest in between for approximately 1-3 minutes, depending on the treatment dose and client’s response. Clinically this is particularly effective for reducing muscular tightness and deactivating painful myofascial trigger points within muscles.
What are myofascial trigger points?
Myofascial trigger points are points of exquisite tenderness situated within palpable taut bands in muscles. These points are often the cause of many pain complaints. If familiar, often referred pain is reproduced on moderate compression of these exquisite tender spots for 4-5 seconds this confirms an active trigger point. Other diagnostic criteria for trigger points include characteristic pain referral patterns, a ‘jump’ sign and a local twitch response which results in a twitchy quivering effect within the muscle when the trigger point is palpated.
What does it feel like when you stimulate a needle using a point stimulator?
When the needle is situated within a myofascial trigger point, gentle stimulation from the point stimulator will cause the needle to twitch gently or pulse. It will feel like a ‘heartbeat-type’ sensation but should not be painful.
What does the research say?
At this stage there is a lack of research evidence to support the use of point stimulators in the treatment of musculoskeletal syndromes. However, this is due to the fact that, to the best of our knowledge, no trials have been carried out. Clinically, however, there is excellent evidence to support the use of a hand held point stimulator as a comfortable and effective way of stimulating needles to de-active myofascial trigger points and, therefore, reduce pain of muscle origin. As such we tend to use the device whenever indicated to complement our integrated approach to physiotherapy care.
Pointer Excel II Instruction Manual, TENS Plus Ind. Co, Hong Kong, http://www.bluemoonhealth.com/Instruction%20Manuals?excel II Instruction Manual.pdf
Baldry P. Acupuncture, trigger points and musculoskeletal pain. 3rd ed. Elsevier; 2005.p.121 [Chapter 9].