What is medical acupuncture/dry needling?
Medical acupuncture, also termed dry needling is a minimally invasive procedure in which an acupuncture needle is gently inserted into an area of muscle called a myofascial trigger point. This is a local, hyper-irritable band of muscle that can refer pain to other areas of the body and/or produce a local muscle twitch. These trigger points can be felt as pea-sized nodules of tissue can be uncomfortable to press into.
Myofascial pain is a common form of pain that arises from muscles or related fascia (a continuous sheath of connective tissue that surrounds muscles, groups of muscles, blood vessels, and nerves). Studies have shown that a surprisingly large percentage of people presenting with musculoskeletal pain will have mysofasical trigger points as their primary source of pain. This can often go undiagnosed, which can lead to chronic pain conditions.
Is dry needling similar to traditional acupuncture?
Although an acupuncture needle is used to treat the trigger points, the therapy is generally based on the traditional reasoning of Western medicine. However, some traditional Chinese acupuncture points may be used depending on the case, as this can produce a positive generalised response. It is a relatively new method of treatment, yet is now widely used by physicians and physical therapists. It is normally used in conjunction with the other techniques such as stretching, manipulation and massage.
How does it work?
The exact mechanisms of dry needling are not known. There is a theory that the body treats the needle as a foreign object and therefore directs local inflammatory mediators to ‘fight’ the unknown object and heal the area. It attracts blood supply which helps flush out the tissue and provide nutrition to the area. The tissue will contract around the needle initially, then release and relax off, which indicates that the response has finished. Based on the pioneering studies by Dr. Jay Shah and colleagues at the National Institutes of Health, these biochemical and mechanical effects help to reduce overall pain levels. The endorphin release can also produce a feeling of euphoria.
Does dry needling hurt?
Superficial dry needling is a relatively painless process. As opposed to deep dry needling, this technique involves inserting the needle into the fatty layer above the muscle. You may feel a little ‘scratch’ as it pierces the skin surface but otherwise you may not feel a thing. The needle is very thin and pliable, so it tends not to pierce structures such as nerves and blood vessels and therefore does not draw blood – hence the term dry needling. There is no statistical evidence to suggest that deep dry needling (where the needle is deeply inserted directly into the muscle) has any greater therapeutic benefit over the superficial method. However, in some cases the twitch response of deep dry needling may be a desirable reaction. Some describe this sensation as an electric shock and others describe it as more like a muscle cramp. If elicited, this response will last less than a second. If I feel this is an appropriate method I will discuss this with you at the time, and explain why this may benefit your condition.
What can be treated with dry needling?
Dry needling can be used for a variety of musculoskeletal problems, where muscles or fascia are thought to be a primary contributing factor to the symptoms. Such conditions include, but are not limited to:
- Neck/Back/Shoulder pain
- Tennis elbow
- Golfer’s elbow
- Carpal tunnel
- Tension headaches and Migraines
- Jaw pain
- Hamstrings strains
- Calf tightness/spasms
- Achilles tendonitis
- Plantar fasciitis
What side effects can I expect after the treatment?
Most patients report that they feel a little sore after the procedure. Typically, the soreness lasts between a few hours and two days. In rare cases the endorphin release may leave a patient feeling ‘spaced out’, dizzy or slightly nauseous. Although this is a rare side effect, it can actually be a very positive response as it normally means that you are a ‘high responder’ to the treatment. However, if you feel this during the process you should let your practitioner know.