Physiotherapy Techniques and Therapies
Dry needling is a physiotherapy technique that consists of eliminating or destroying the myofascial trigger point (MTP) by pricking it with a needle.
The MTrP is a tight band in the muscle, a kind of “knot” that causes referred pain, sometimes far away from the point itself. For example, a PGM in the thigh may give pain referred to the knee or a PGM in the back may give pain referred to the chest.
The technique consists of palpating the PGM and inserting the needle to destroy the motor plate and stimulate the neuromuscular spindle and produce reflex muscle relaxation. The muscles are immediately asked to do eccentric work to allow them to adjust and integrate the changes achieved.
The success of the technique lies not only in correctly puncturing the PGM but also in correctly diagnosing which muscle to puncture. We cannot be guided by pain because in many cases, the pain is not in the causal muscle, the one that causes the injury, but in the reactive one, the victim who suffers it. As an example we have the case of the trapezius: in many occasions, we have a PGM in the right trapezius but it is remotely rare that the right trapezius is causal or primary, it is usually responding to a tension of the left trapezius or the right latissimus dorsi, which is much more silent.
In this case, it would be a major mistake to puncture the PGM of the right trapezius, even if we have contracture and pain in it, without first having punctured the left trapezius or treated the latissimus dorsi; doing so could temporarily relieve the pain but the consequences in the short and medium term would be worse.
And this brings us to another important aspect of dry needling, which is that we cannot use this technique with all muscles.
We must subject it to the physiopathology of each muscle. This means that there are muscles that, when injured, tend to fibrosis, retraction, such as the biceps, pectoralis, latissimus dorsi, etc. And these muscles do not react well to dry needling because they tend to defend themselves against the needle with more fibrosis and retraction. However, others such as the soleus, gluteus or trapezius normally respond very well because their pathophysiology is excess tone and with the puncture we break the order of constant contraction to which they are subjected.
It is also worth mentioning that dry needling is a painful but very effective technique for treating PGM and myofascial pain, however, the patient can always decide during the session whether they want to continue or rest.
A Holistic View
Their description during the patient interview reveals much of the information about the injury.
THE KEY: is to find the reason for the injury, the cause. What is the chain of injury that has caused it.
Always based on an accurate, personalised and innovative diagnosis.