Most people have experienced knots within their muscles. These knots or areas of increased tension can occur from under-use, over-use or misuse of muscles. The actual mechanism of why this occurs is somewhat controversial but is likely due to a combination of neural, chemical, and mechanical factors. These areas of muscle tension can alter movement patterns and begin a cycle of pain and inefficient movement. To resolve these types of conditions, the area of tension and the movement patterns must be addressed.
Dry needling is a novel treatment that physical therapists can use to treat muscle pain. A very fine needle is inserted into areas of tension within the target muscle. Unlike hypodermic needles used for injections, the needles used for dry needling are beveled and wiggle their way through the tissues rather than cut through them. These are same the needles used for acupuncture, but this is where the similarities end. Instead of targeting qi points or meridians like acupuncture, the PT will target specific points of tension within muscles that are contributing to your symptoms. The needle entering the muscle triggers neurologic, chemical, electrical and biomechanical changes that can help to reduce stiffness and pain, increase blood flow and restore normal mobility. Once pain and stiffness are reduced, it will be easier for your body to perform exercises and activities in the most efficient and pain-free manner.
So, now that you know what dry needling can do, you’re wondering what to expect when you receive a dry needling treatment. Your physical therapist will do a thorough assessment of your condition, movement patterns, and history to determine which specific muscles and structures are contributing to your pain. Once your PT has identified which muscles are causing problems, they will palpate or feel the muscle to identify the specific location of muscle tension. These areas will often be more tender than the rest of the muscle. The PT will then clean the area and tap a needle into the skin. Just to be clear, all needles are individually packaged and only used for one patient (I have been asked this before!) The therapist will elect to leave the needle stationary, perform “pistoning” (moving the needle up and down) or use electrical stimulation to help the target muscle to activate, depending on which one the therapist determines will produce the greatest immediate results. The needle will then be removed, and you will perform exercises targeted at restoring the optimal movement patterns for the given body part.
When the needle is in the target muscle, the most common feeling is a deep ache. It is very normal for you to feel sore afterward as if you completed an intense workout. After needling, it is important to stay active and use the treated muscles to help them return to optimal movement patterns. While dry needling is not a magic cure for all pain, it is a powerful tool that physical therapists can use to help reduce pain and restore optimal movement patterns. If you are interested in dry needling or think that you could benefit from it, discuss options with your PT!
Authored by Dr. Robert ‘Kit’ Durban PT, DPT, ATC
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