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Could dry needling be the answer?

‘Dry needling’ or ‘Western acupuncture’ is a physical therapy technique used by healthcare practitioners to treat musculoskeletal pain and stiffness.

The technique uses extremely fine needles to stimulate myofascial trigger points (MTrP) to help reduce muscle tension, increase range of motion, improve blood flow and initiate healing in the tissues. (It is important to note that this is different to Acupuncture.)

If your main experience of needles so far has been of the larger hypodermic needle type, then you may be understandably hesitant. However, dry needling is a vastly different experience, using very thin, solid needles in a therapeutic way.

The term dry needling was first introduced in 1979 and as an osteopath I have heard countless reports from patients who have hugely benefitted from dry needling for pain relief and mobility issues, especially in situations where other treatments weren’t working or the patient couldn’t tolerate more dynamic treatments due to the level of pain and stiffness. (Scientific studies are limited but have reported dry needling to be effective in treating pain caused by MTrP.)

The aim of dry needling

Myofascial trigger points are tender spots or ‘knots’ in a taut area of muscle that occur due to overuse causing an energy crisis in the muscle. This happens through prolonged postures such as sitting at a desk; chronic stress; injury; awkward postures, such as plumbing or repetitive actions, such as painting.

When the muscle is working too long, the fibres bunch and cannot relax. The blood supply is reduced and the increasing acidic environment sensitizes the surrounding nerves to result in pain to that area and other areas also served by those nerves (referred pain).

It is thought that activating the disruptive MTrP with a needle activates the associated nervous system, attracting blood back to that area and releasing the tension, also stimulating the brain to release endorphins that further reduce pain.

The needles used are between 0.22 mm and 0.32 mm in diameter depending on area of the body and patient sensitivity. N.B. a human hair is approximately 0.1 mm and an average hypodermic needle 1.6mm.)

Dry needling is usually part of a wider treatment plan including treatments such as massage, stretching, and exercise.

What to expect from treatment

  • Medical history and physical exam to assess suitability of treatment.
  • Explanation of possible treatment and obtaining of consent to proceed.
  • Trigger point is palpated, probably tender, and a needle tapped into the skin using a plastic tube guide to control the initial depth. This is often painless or gives a small sharp sensation.
  • The needle is pushed deeper in to or near the trigger point. It may be twisted or pumped up and down.
  • A muscle twitch/small spasm response shows the MTrP is activated. The patient may feel a local ache/soreness, referred pain, muscle tightening or relaxing.
  • Post treatment there may be immediate or delayed improvement in pain and mobility or some soreness and stiffness that should resolve after 24-48 hours.
  • Other side effects, often minor, can include bleeding, bruising, fainting and fatigue.

It is important to share all your reactions, including no reaction, with your practitioner to accurately plan future treatments.

Is it for you?

Although generally considered a minimally invasive and low risk technique, dry needling is not suitable for everyone and is not advised for people who: have a current infection; a fear of needles; do not understand the treatment; are pregnant or children under 12. There are also medical conditions (which we will check with you before treatment) where it is contraindicated.

If you would like to discuss, or book an appointment to try, dry needling in conjunction with osteopathy, please do get in touch.