Posts

Spinal Dynamics of Wisconsin - Milwaukee

What is Trigger Point Dry Needling?

Spinal Dynamics & Body Dynamics of Wisconsin has found trigger point dry needling to be a very effective treatment option for people with pain or dysfunction. In fact, our clinic was among the first physical therapy clinics in Wisconsin to provide dry needling as a treatment option. Since trigger point dry needling is a relatively new treatment option in the United States, patients often have a lot of questions. Below are a few questions we hear most frequently in the clinic.

What is a trigger point? A trigger point is an area of contracted muscle fibers that may feel like a taut band or a “knot”. When a trigger point is present, that area of muscle cannot appropriately function to contract or relax, and often causes pain and/or weakness. Trigger points may be caused by overuse, injury, or prolonged postures. They can cause pain either in the local area around the trigger point or refer symptoms to another region.

SCM

The sternocleidomastoid muscle starts just behind the ear and attaches to the clavicle (collarbone) and sternum (breastbone) of the chest. Trigger points in this muscle can cause referred pain to the areas in red. Trigger points in the sternocloidomastoid are often involved with headaches. Most muscles have a specific referral pattern, which may be close to the muscle or refer further away.

What is dry needling?  Dry needling is an treatment procedure in which a solid filament needle is inserted into the skin and muscle directly into a myofascial trigger point. Trigger point dry needling works to deactivate the trigger point to improve pain, range of motion and function.

How does trigger point dry needling work? With trigger point dry needling, the needle is inserted directly into a myofascial trigger point. By moving the needle around within the muscle, the muscle may experience a twitch response, where it contracts and relaxes. This twitch is important in deactivating the trigger point. 

Is dry needling similar to acupuncture?  Dry needling and acupuncture both use solid filament needles, but are different techniques. Typically, acupuncture is based on Chinese medicine principles, including meridians and acupuncture points. In contrast, trigger point dry needling is strictly based on Western medicine principles and research. With trigger point dry needling, the needle is typically inserted directly into the muscle to treat a trigger point. 

What type of problems can be treated with dry needling?  Dry needling can be used for a variety of musculoskeletal problems. Conditions include, but are not limited to:

  • Neck pain (with or without arm or shoulder blade pain)
  • Low back pain (with or without hip or leg pain)
  • Shoulder pain
  • Arm pain, including tennis elbow, carpal tunnel, golfer’s elbow
  • Migraines and tension headaches
  • Temporomandibular joint dysfunction (TMJ pain or jaw pain)
  • Hip or buttock pain
  • Leg pain – including sciatica, hamstring strains, calf strains, IT band pain
  • Achilles or plantar fascia pain
  • Fibromyalgia, myofascial pain syndrome

Chronic injuries, in general, may involve trigger points that may benefit from dry needling.

Is the procedure painful?  Because the needle is so thin, most patients do not feel the insertion of the needle into the skin. As the needle is relocated into the muscle, a local twitch response can elicit a quick uncomfortable or painful response as the muscle contracts, then relaxes.  Some patients describe this as a little electrical shock, while others feel it more like a cramping sensation. Once the trigger point is released, pain generally will decrease. Trigger point dry needling is generally well tolerated.

What side effects can I expect after the treatment? Patients may report being sore after the procedure.  The soreness is usually described as muscle soreness over the area treated and into the areas of referred symptoms.  Typically, the soreness lasts somewhere between a few hours to a day or two, but generally does not limit activity. In fact, some athletes undergo dry needling treatment shortly before practice or competition to assist with performance.

How long does it take for the procedure to work? Patients may notice some change in symptoms quickly, including improved range of motion or stiffness. Typically, it takes several treatment sessions for a more long-term change to take place.  Trigger point dry needling works best in conjunction with other treatment methods, such as soft tissue mobilization, strengthening exercises and stretching, so it is important to not just rely on dry needling.

Why is my doctor not familiar with this technique? Trigger point dry needling is relatively new in the United States, but is gaining significant popularity in the pain management and physical therapy fields. It has been utilized in other countries for decades.

In the past, physicians often utilized injections with lidocaine or other anesthetics to assist with deactivating trigger points. Research shows that the needle itself may be more important than the anesthetic in deactivating trigger points. Dry needling is typically less costly than an injection and more efficient, as physical therapists are able to treat multiple areas if appropriate, or treat trigger points more frequently.

Are the needles sterile?   Yes, we only use sterile disposable needles.

Do I need a referral for physical therapy and/or dry needling? Wisconsin is a direct-access state, which means that patients are allowed to see a physical therapist without a referral. Most insurance companies do not require a referral to physical therapy, but it is prudent to make sure prior to treatment. You can either call your insurance company to check or give our office a call and we can help you determine if you need to talk to a physician prior to seeing a physical therapist. Most insurance plans do cover trigger point dry needling under routine physical therapy billing, but our office can help you determine if your plan has any limitations.

All of our physical therapists are trained in dry needling. More questions? Give us a call at 414-302-0770.