Would You Benefit from Dry Needling?
Frequently patients often wonder why they have continued pain when the diagnostics they have received offer no explanation. For example, the x-ray and MRI are normal, and their providers may not have a clear answer why they have pain. The discomfort persists and subsequently range of motion becomes restricted, or muscle strength becomes impaired. Activities of work, home, or recreation is affected too.
A possible explanation is the myofascial trigger points in the muscle or tendon sheaths. Myofascial trigger points are defined as “hyper irritable” spots in the skeletal muscle that are associated with hypersensitive palpable nodules in a taut band. In other words, deep trigger points that one can feel and with pressure applied can intensify the pain. Often the pain is referred into other areas of the body part. For example, it may be a shoulder problem, but the pain is much more pronounced down the lateral arm or into the elbow.
Manually trained physical and occupational therapists are adept at palpating such areas and thus can focus on treating these spots with deep trigger point massage using their hands, thumbs, or even specially made tools. These tender areas can cause abnormal muscle contractures or demands on a nerve which can cause a prolonged shortening of the muscle.
Dry needling into these hyper irritable spots is very effective in alleviating pain and tightness. Dry needling is done with accupuncture needles. However, this technique it is not acupuncture. Dry needling, is performed on inflamed or nearby muscle that is the anatomic problem. Trained therapists’ exam and locate the anatomical points based on the patient’s anatomy, neurology, and physiology. The needle is then safely inserted into the trigger point that is responsible for the patient’s pain or dysfunction. Accupuncture needles are very fine needles with a very small diameter. Once the trigger point is appreciated through palpation the needle is inserted in the connective tissue. The needle can then be rotated and moved about which causes a “winding of the collagen tissue”. This causes the connective tissue to follow the needle in establishing a mechanical bond between the needle and the tissue. Subsequently, this interaction allows a stretch to occur in the intermuscular connective tissue. What follows is a specific and deep stretching of the deep tissues. The patient feels that the muscle has relaxed and become “free”. Movement patterns feel more fluid and are restored. Exercising and stretching becomes easier and more effective.
In 1984 the Maryland Board of Physical Therapy was the first state board in the US to approve Dry Needling to be within the scope of the physical therapists practice in the United States and many countries around the world. Recently, therapists were mandated to have at least 60 hours on theory and classroom training on performing Dry Needling
Currently, The Centers for Advanced Orthopedic- MMI Division has five physical therapists certified to perform Dry Needling. You can speak to one of these providers by calling the Hagerstown, Urbana, or 165 Thomas Johnson Drive offices. Don’t hesitate to call or speak to your provider if you think this treatment may be beneficial.