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In the past decade, a modality called dry needling has gained traction in the rehab and pain management communities to address neuromuscular pain and/or dysfunction. It’s not for everyone, but it can have very powerful results. 

Dry needling is defined as a skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular, and connective tissues for the management of neuromusculoskeletal pain and movement impairments. Trigger points are taut bands of muscle tissue that are irritable to stimuli of compression, stretch, or contraction of the tissue. People will sometimes refer to them as “knots”. There are several theories as to how these trigger points develop, and the most popular theories involve overuse of a particular muscle band that results in the painful taut band.

Trigger points often refer pain to other parts of the body. All of the muscles in the human body have common pain referral patterns. For example, a painful sensation in the hand could really be referred from muscle dysfunction in the shoulder. A common site that people will experience this type of referred pain is in the head. It could be mistaken for a headache but actually be referred from the neck. Good clinicians assess areas above and below the involved area, in order to determine the root cause of the pain and dysfunction. 

The below image represents referral pain sites as red dots from the trigger points marked with ‘x’ – in this example it’s the sternocleidomastoid muscle that can refer pain to the head.

Dry needling is not to be confused with acupuncture. Although the type of needle is the same, they are different treatment methods. Dry needling is performed with the intent of releasing trigger points in muscles or surrounding tissues. Acupuncture is rooted in traditional Chinese medicine, as an alternative treatment for medical conditions, with the philosophy of releasing chi (energy flow) in particular manners. Both can be used for treatment of pain, but the approach is vastly different.

Sometimes electric stimulation (e-stim) is coupled with the dry needling. This is referred to as intra-muscular electric nerve stimulation. You may be familiar with TENS, which is transcutaneous electric nerve stimulation – utilizing sticky pads that are placed on the skin over the painful area. The same electric currents are used, but they are delivered directly into the muscle tissue via the inserted needle(s), so the stimulation can be more isolated to the muscle we wish to target. 

Dry needling is an intervention that we are oftentimes in favor of. It’s not for everyone and every condition by any means, but it can certainly be a game changer when used appropriately!

Watch the video below for a peek at what dry needling looks like in action.

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