On other occasions we have talked about the physiotherapy technique called dry needlingwhich can be used to relieve muscle pain originating from trigger points (also known as myofascial pain syndrome).
But we do not want to get too technical, because the objective of this entry is to give an explanation for patients on the use of dry needling: when it is indicated and what problems and annoyances it can help to solve.
What does dry needling consist of?
The dry needling It is an invasive physiotherapy technique that consists of introduction of needles through the skinwithout injecting or extracting any substance (hence “dry”), since the therapeutic effect is achieved by mechanical needle action. To apply it, the physiotherapist must properly assess the patient.
The dry needling It can be applied to many muscles. The main indication for dry needling, as we said in the first paragraph, is to treat the pain caused by trigger points.
The physiotherapist palpates the trigger points, and will assess, also asking the patient, if these points are painful and if pressing them reproduce aches or pains that the patient relates to his usual pain (the pain that has motivated the consultation).
The trigger points frequently give referred pain, that is, they are “reflected” in body regions far from the trigger point. This should also be assessed on examination, when the physical therapist presses and explores the trigger points. These areas are very sensitive and painful, and it is where the puncture is applied, as you can see:
One of the characteristics associated with the puncture is the appearance of “muscle spasms”. In the previous video they can be seen quite well (for example, from minute 1:06). Are rapid and jerky muscle contractions. They are not movements that the person makes voluntarily, nor are they due to pain. They are a response to the puncture.
Dry needling indications
Although still solid evidence needs to be established In certain treatments, dry needling has been shown to be effective in:
- Shoulder: muscle problemshemiparesis, subacromial syndrome and adherens capsulitis.
- low back pain (It will have to be assessed, since it depends on the causes of pain).
- Radiculopathies and cervical painpain due to whiplash,
- plantar fasciitis
- Tendinopathies
- Some headaches and migraines
- Joint pain in the knee and other joints
There are more indications, but I have highlighted some of those that affect frequent injuries.
As always when we talk about a technique in isolation, it must be said that the diagnosis and assessment are fundamentalbecause each case is particular and will require techniques and treatment guidelines that will vary from one person to another.
In the case of muscle and joint problems, in which dry needling can help, it is always necessary to add guidelines such as specific exercises Y learn guidelines and corrections that prevent the pain from reappearing, avoiding postures, gestures or efforts that cause the reappearance of pain, in addition to applying physiotherapy techniques and medical or other treatments that are relevant.
Mechanisms of action of dry needling
if we ask what does dry needling do for pain reliefthe question is complex, and still there is a lot of research going on to explain how and why dry needling results are produced.
As a summary (and making inaccuracies, for short), we can say that the mechanical effect of the needle influences the stimulation of nerve fibers, produces an indirect action that causes the release of substances that inhibit pain (endorphins and the like), there is also a decrease in substances accumulated in the trigger point area and that influence sensitivity and increase pain, effects on blood flow, anti-inflammatory effect and others.
Contraindications and precautions of dry needling
It is essential that the physical therapist explores and assesses contraindications, and explain them to the patient. You should also explain that it is a technique that can bother you at the moment (remember, it is a needle) and that even there may be discomfort the day or days following the application.
All doubts must be clarified and it is necessary that the Information is given verbally as well as in writing.; that is, informed consent is necessary, something very important in physiotherapy.
In conclusion, we can say that dry needling is a technique that can be useful in certain muscle problems (myofascial) and that it goes a long way, since there are variants such as electropuncture (combining dry needling with the application of analgesic currents through the needle itself), different techniques of puncture to achieve different effects and also, conservative method (puncture and treatment of trigger points using the hands), for cases in which the use of needles is not indicated.
This article was originally published by Miguel López Pareja in June 2017 and has been revised for republication.
Image | Pexels, Unsplash
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