DRY NEEDLING THERAPY

Dry Needling is a physical therapy technique that consists of eliminating or destroying a myofascial trigger point by pricking it with a needle.

A myofascial trigger point is a tense band in the muscle, a sort of “knot” that causes related pain, which is at times far from the trigger point itself. For example, a trigger point in the thigh can cause related pain in the knee, or one in the back can cause a related pain in the chest.

This technique consists of palpating the myofascial trigger point and inserting a needle to destroy the motor end plate, stimulate the neuromuscular zone and produce a reflex muscle relaxation. It immediately makes an unusual request of the muscles which lets these changes take place and be integrated.

The success of this therapy lies not only in correctly needling the trigger point, but also in accurately diagnosing which muscle to needle. Pain cannot be used as a guide because in many cases it is not found in the muscle that is producing the injury but rather in a reactive muscle, where the pain is felt. As an example, we have the case of the trapezius muscles: there is a trigger point in the right trapezius, but it is quite rare for it to be the cause or primary point. Normally it is responding to tension in the left trapezius or the right-side latissimus dorsi, which is much more “silent”.

In this case, it would be a major mistake to needle the trigger point in the right trapezius muscle, even though that is where the contraction and pain is. Prior to doing this, the trigger point in the left-side trapezius should be needled or the latissimus dorsi should be treated. Doing the right side might eliminate the pain temporarily, but the short and mid-term consequences would be worse.

Another important aspect of Dry Needling is that this technique cannot be used with all muscles.

We must yield to the physiopathology of each muscle. That means that there are muscles which, when injured, tend to fibrosis and retraction, such as the biceps, pectoral muscles, latissimus dorsi… These muscles do not respond well to dry needling because they tend to defend themselves from the needle with increased fibrosis and retraction. However, others, such as the soleus, gluteus or trapezius generally respond well because their physiopathology is an excess of tone, so needling disrupts the command to contract constantly that we are experiencing.

It also bears mentioning that dry needling is a painful but very effective technique to treat myofascial trigger points and pain. Nevertheless, the patient can always decide during the session whether to continue or to take a break.