Trigger Point Dry Needling is a technique that can help to manage your pain symptoms. It is a technique used to treat trigger points using solid filament needles. There is a growing amount of research which supports this technique in treating a number of musculoskeletal conditions.  The following are some commonly asked questions about trigger point dry needling that should help give you a greater understanding of how it may help you and what you can expect.

1. What are trigger points?

Trigger points are tight irritable areas within your muscles, what many of us call “muscle knots.”  They may start from a specific injury or repetitive stresses.  Trigger points do not get enough blood flow (ischemia) or oxygen (hypoxia) because of the tight contraction in the muscle and can lead to poor muscle activation and limited range of motion. They can cause pain where they are located, or may send pain to another area of the body.  For example, trigger points in your piriformis muscle may send pain into the back of your thigh, and trigger points in your neck muscles may cause headache pain.

2.  What is trigger point dry needling? How is different from a trigger point injection?

Trigger point dry needling is the use of a solid filament needle inserted into a trigger point.  It is called “dry” needling because the needle itself is the treatment; there is no medication or other liquid substance being injected. This is in contrast to a trigger point injection, which involves injecting medication into the trigger points with a hypodermic needle. Some research indicates that there is no significant difference between dry needling and trigger point injections, so this is an excellent medication-free alternative treatment.

3. How does it work?

Inserting the needle creates mechanical, chemical, and neurophysiological changes in the muscle.  These changes lead to improved blood flow and oxygen in your muscle, improved range of motion, decreased irritability and sensitivity of your muscle, and improved activation of your muscle. By improving blood flow and desensitizing the trigger point, we are placing your muscle in the optimal position to heal in order to return the muscle to normal, painfree function.

4. How is it different than acupuncture?

While both techniques use the same type of filament needles, they have different goals. Acupuncture is a Traditional Chinese Medicine technique with a goal of balancing energy flow (qi) through the body’s meridians. Trigger point dry needling is a Western medicine technique which specifically treats trigger points and associated symptoms.

5. Am I certified to perform this technique?

My name is Katie Moulison,DPT and I am a staff PT at OrthoWell Physical Therapy. Yes, I am certified and have been preforming dry needling for the past 2 years. In order to perform trigger point dry needling in the state of Massachusetts, training is required.  I am certified through the American Dry Needling Institute. I have a strong knowledge of anatomy and 2 years of experience successfully performing this technique.

6. What conditions can benefit from this technique?

Trigger points have been identified in many different diagnoses including:  radiculopathies(nerve pain), disc pathology, tendonitis, temporomandibular joint dysfunction (TMJ), headaches, carpal tunnel syndrome, whiplash, and joint dysfunction.  This is not an exhaustive list, and we would be happy to discuss whether or not trigger point dry needling may be a beneficial treatment technique for you.

7. What happens during my treatment?

After a thorough evaluation, we will determine if trigger point dry needling is appropriate for you.  The first step is to palpate your muscle to find where your trigger points are.  After thoroughly cleaning your skin, the small filament needle will be inserted.  I perform a gentle pistoning movement of the needle while it is inserted in order to stimulate the trigger point. Depending on the goal of your treatment, the needle may remain in place for 30 seconds to 3 minutes.  You may feel a jump in your muscle, called a local twitch response. While the needles are inserted, there should be no pain from the needle, but you may feel a temporary reproduction of “your symptoms.” For instance, if we are working on your neck, you may feel a reproduction of your headache symptoms.   We may also decide to add electrical stimulation to your treatment to further intensify the benefits of the treatment.   After the needles are removed, gentle massage will be performed in that area.  This gentle massage helps to reduce the risk of post-treatment soreness.  Your treatment will also consist of an individually designed exercise program intended to address the reason why these trigger points formed and help prevent their return.  Each step of the process will be explained to you as we move through the treatment, and any questions and concerns will be answered.

8. How deep are the needles inserted?

Depending on the goals of your treatment and the area we are treating, we may stay on the surface of the muscle, or we may need to go deeper.  For instance, some of our hip muscles, such as the piriformis, are deeper and require a larger needle.  The needles range in size from 1-4 inches, and all needles used are very thin.

9. What can I expect from treatment? Are there any side effects?

Though unlikely, there are some risks associated with this procedure. These risks include bleeding, infection, nerve or vascular injury, feeling faint, or penetration of an organ. Precautions are taken to avoid all of these risks, including using sterile needles which are only used on you and are disposed of after each treatment.  You may have some discomfort in the region of treatment for up to 48 hours; this is a normal reaction, occurring in approximately 10% of patients.

10. How many treatment sessions will I need?

Depending on the nature and severity of your symptoms, you may need a total of 2-8 sessions to achieve maximum benefit. Most patient require around 6 sessions for maximum benefit.

Please let us know if you have any other questions.

Dr. Katie Moulison

Testimonials:

“I have been a patient receiving physical therapy for a number of years. The lower back pain I have is the result of a herniated disc in July 2008. Originally, I went to physical therapy at Sports Medicine North, in Peabody. Since then I’ve been a patient at OrthoWell Physical Therapy for the last four years.

During the past two weeks I have experienced Dry Needle Therapy at OrthoWell Physical Therapy. Kathryn Murphy is my therapist. She has done any excellent job explaining how this therapy works and what I should expect after each session. I have two more sessions left and then she’ll evaluate my progress. I feel a lot less pain in my lower back. In comparison to the way I felt two weeks ago I would say I have improved at least 70%. The therapy is not painful or even uncomfortable yet the effect is a much improved condition for my lower back. I feel more comfortable as I do the things I enjoy. I don’t need to rest during the day. I enjoy activities all day long. Sometimes I am babysitting out two year old and our four year old grandchildren. I can stay out of the house most of the day doing shopping, errands, or visiting friends without discomfort. Dry Needle Therapy has really worked to decrease the level of pain substantially.

I definitely would recommend Dry Needle Therapy to anyone who experiences back pain and sciatica nerve pain.” – Theresa N.

“My experience with dry needling was very positive. I was experiencing constant pain in my lower back L4/L5 and L5/S1, that worsened with stair climbing and bending with rotation. There were residual muscle spasms from a back injury in July 2014, that were not responding completely to stretching ex’s or other devices used to treat spasm. The dry needling made a difference after the first treatment, and after 4 treatments I feel that I am ready to be discharged.” – Cheryl J.

Here is some more information form the American Physical Therapy Association on dry needling

DryNeedling-APTA Descript ion

DryNeedling-APTA  coding