DRY NEEDLING

Dry needling is a therapy for muscle or nerve pain. It can be referred to as myofascial trigger point dry needling or intramuscular stimulation. The term “dry needling” comes from the use of a needle without a liquid or medication in or on it.

Acupuncture and dry needling techniques are at times identical, depending on the style of practice of the practitioner. For example, tendinomuscular acupuncture relies on careful palpation of what are called "ah shi" points, which can be translated as “there it is” points. The ah shi points often correspond to both trigger points and/or motor points in the myofascial tissue. Acupuncture can use other theories of why to treat certain points. Thus, while some forms of acupuncture are not at all the same as dry needling, the term dry needling can refer quite specifically to what is now called Myofascial Acupuncture or some versions of Sports Acupuncture.

The origin of the term “dry needling” is attributed to Janet Travell, MD. In her book, Myofascial Pain and Dysfunction: Trigger Point Manual, Dr. Travell uses the term "dry needling" to differentiate between injection of a local anesthetic and the mechanical use of a hypodermic needle without injecting a solution. The use of a hypodermic needle for dry needling was also described by Dr. Chang-Zern Hong in his research paper on "Lidocaine Injection Versus Dry Needling to Myofascial Trigger Point”. Both Travell and Hong used hypodermic needles for dry needling. However, now many healthcare practitioners who perform dry needling have found that the solid filiform (acupuncture) needles not only provides better tactile feedback but also penetrate the "dense muscle knots" better and are easier to manage and caused less discomfort to patients. For that reason both the use of hypodermic needles and the use of acupuncture needles are now accepted in dry needling practice.

Dry needling for the treatment of myofascial (muscular) trigger points is based on theories similar but not exclusive to traditional acupuncture. Both acupuncture and dry needling target the trigger points, which is a direct and palpable source of patient pain. However, dry needling theory is only beginning to describe the complex sensation referral patterns that have been documented as "channels" or “meridians” in Traditional Chinese Medicine. Dry needling, and its treatment techniques and desired effects, would be most directly comparable to the use of “ah shi” points in acupuncture. What further distinguishes dry needling from traditional acupuncture is that dry needling does not use the full range of theories of Traditional Chinese Medicine which is used to treat not only pain, but other non-musculoskeletal issues which often are the cause of pain. The distinction between trigger points and acupuncture points for the relief of pain is blurred. As reported by Melzack, et al, there is a high degree of correspondence (71% based on their analysis) between published locations of trigger points and classical acupuncture points for the relief of pain.

Dry needling can be a valuable, effective and efficient adjunct treatment in muscular pain. The purpose of this technique is to inactivate the myofascial trigger points by producing a local twitch response. This local twitch response then releases the shortened bands of muscle fibers. The result is muscle relaxation and pain relief. Eliciting this local twitch response is key for successful deactivation of the trigger point. Inactivation of the trigger points can bring immediate relief of symptoms.

The advantages of dry needling over other treatments are that we can treat parts of the muscle, and deeper layers of muscles, where our hands and fingers cannot reach. Also, this method is far superior in achieving a local twitch response over other manual techniques. In addition, there are no drugs used so we can treat many trigger points during each treatment.

Thus, results are achieved with dry needling which cannot be obtained with any other treatment.

Dr Van Antwerp and Dr Keefe have been using dry needling in conjunction with acupuncture as part of their treatment protocols.