Dry Needling is an acupuncture-like treatment used in therapy. Also known as intramuscular stimulation (IMS), this treatment is used to reduce muscular and myofascial (1) pain, release trigger points, and restore movement.
It may be used to treat a chronic condition or an acute episode particularly when there is no obvious cause of injury, i.e. repetitive strain injuries (RSI). Every muscle in your body is comprised of numerous muscle fibers, which generally line-up in the same direction. This structure helps each of your muscles produce the greatest possible amount of power. To do this, the fibers need to glide and move freely. However, through a lack of mobility the fibers within the same muscle, or between different muscles located next to each other, can stick together and form what is felt as a thickening or knot.
These adhesions can also be felt as taut and tender spots in the connective tissue or in the fascia which surrounds muscles, resulting in myofascial knots and trigger points. These adhesions can form when your muscles are held in a shortened position for a long period of time, such as sitting at a desk with poor ergonomic support. Trigger points can also result from contusions (bruises) or repetitive stress, such as the pain you may feel in your forearms due to typing.
Eastern vs. Western Acupuncture
Dry Needling is considered to be the Western approach to acupuncture. It focuses on the biomechanics of the body, emphasizing the importance of human body’s structures and movements; rather than the energy channels used in Traditional Chinese Medicine (TCM).
The practice of dry needling began in the 70’s when North American Physicians wondered what would happen if they stimulated trigger points in the muscles using only the needles, instead of injecting local anesthetics. The term dry needling was chosen because nothing was being injected through the needles.
Ever since its introduction a number of studies have shown there is as much benefit from dry needling in the treatment of musculoskeletal pain as there is with the injection of different substances, including corticosteroids and analgesics.
These results prompted me to study dry needling as well as acupuncture to treat muscular and myofascial pain. Although I use both techniques, in my practice I have found dry needling helps my patients recover faster and I often use it in conjunction with manual therapy and other more traditional physiotherapy modalities.
What is the difference between acupuncture and dry needling?
In TCM, besides the points established along meridians (energy channels), individual points (2) are frequently targeted to treat myofascial conditions. These points often resemble trigger points and/or motor points in the tissue. In contrast, dry needling directly targets localized trigger points regardless of their relation to meridians. Depending on your healthcare practitioner’s approach, Dry Needling and Acupuncture points may or may not be identical. However, even when the points are identical, the two techniques can be rather different. By inserting needles through the skin, fascia, and into tense muscle fibers, dry needling directly releases knots and trigger points. These fine needles are similar to – or often the same as – acupuncture needles. However, they are not left inserted in the muscles for an extended period of time. Instead, they are moved in and out of the trigger points to elicit a contraction, twitch or “popping” sensation in the muscle fibers.
How does Dry Needling work?
Dry needling restores your muscle fibers’ natural movements and reduces restrictions that impede mobility. It helps to restore muscle efficiency through contraction and relaxation of specific fibers. This technique can also release endorphins – the body’s naturally occurring morphine which reduces pain!
By inserting a needle into a tense muscle an involuntary contraction or twitch may occur. These local twitch responses (LTR) have been shown to improve treatment outcome (3). The quick contraction causes the adhesion in between muscle fiber to break down and improves the movement of the muscle. As the fibers shorten and pull away from the trigger point the result is a release of tension and relaxation of the muscles.
Is Dry Needling painful?
Here at the Orthopaedic Therapy Clinic we commonly believe in a “No Pain, More Gain!” model of treatment. However, Dry Needling is one of the few techniques in which some pain can result in more gain!
When inserted into a relaxed muscle at rest, needles face minimal resistance as they move through muscle fibers and there is little to no discomfort. However, the higher the tension, the more resistance there is to the needles entering the muscle. The result is that you may experience a quick cramp-like sensation with a local twitch response when trigger points are targeted directly. For this reason, some patients may find the application of dry needling more uncomfortable than traditional acupuncture. After a treatment you may feel a localized soreness for up to 48 hours after a dry needling treatment session. It is important to allow an adequate amount of time between dry needling treatment sessions to let your body’s natural healing process to take place after each treatment. Treatments are typically scheduled once this localized soreness has resolved.
Who benefits from dry needling?
As a practitioner, I use both acupuncture and dry needling to treat acute as well as more persistent or chronic conditions. Considering that breaking down adhesion is not the primary focus of acupuncture, I find dry needling more effective when dealing with chronic tightness and cramps in muscles and fascia; particularly when there is a plateau in recovery with other treatment techniques. Dry needling is beneficial in combination with other physiotherapy treatments (strengthening muscles, manual therapy, soft tissue release, etc.). I recommend this technique for treatment of a number of conditions; including, but not limited to:
- Conditions associated with poor posture (i.e. Postural dysfunction),
- Headaches and neck pain,
- Back pain,
- Repetitive strain injuries,
- Muscle strains,
- Concussion related symptoms
If you experience knot-like pain in your muscles that does not settle with other types of therapy, restricted range of motion or functional limitations; or if you feel that you no longer get lasting relief from other types of treatment, contact Milad Bazaz at the Orthopaedic Therapy Clinic to set up an appointment for a thorough assessment and to discuss whether dry needling is a treatment option for you.
- Myofascia is a dense and thin layer of tissue that covers muscles and bones in the body.
- Called Ah shi points
- APTA (American Physical Therapy Association)