Myofascial Trigger Point Dry Needling for Myofascisal Pain
What is a Trigger Point?
A trigger point is a tender, palpable nodule in the muscle. Trigger points can cause local and referred pain, tightness, decreased flexibility, and joint dysfunction that can contribute to the pain cycle.
What is Trigger Point Dry Needling (TPDN)?
TPDN involves inserting a thin solid filament needle directly into a muscle at the myofascial trigger point or “knot.” No medication is injected, hence the term “dry needling.”
How does it TPDN work?
TPDN will cause a local twitch response, in which the muscle fibers contract. This results in muscle relaxation and release of the shortened muscle fibers. Essentially, it causes a knot to release. This allows an automatic increase in blood flow to the involved area and eliminates pain producing chemicals, which allows increase in oxygenation, improves soft tissue mobility/flexibility, and allows more recruitment of muscle fibers when you go to use that muscle. Think of a muscle having only so many muscle fibers. Say, for instance, in the case of the shoulder, your infraspinatus, which is an external rotator of the shoulder has 100 muscle fibers (it has thousands but for the sake of simplicity there is 100). Fifty of those are wound up in knotted positions. You are automatically going to test 50% weaker because when you go to use a muscle, the muscle fibers need to cross over and shorten. If muscle fibers are already in a shortened position, they can’t shorten any more.
The results are amazing, though the procedure is not always “fun.” While the procedure is being performed, you may feel a pain referral pattern in a place away from the site of the needle insertion (see images below). This often happens when you hit a large, active myofasical trigger point. I like to think of it as temporary discomfort in exchange for decreased pain. In my opinion, the trade-off is worth it.
What types of problems can be treated with dry needling?
TPDN can be used for a variety of musculoskeletal problems where muscles are a contributing factor to the symptoms. Conditions such as low back pain, neck pain, shoulder pain and decrease motion, rotator cuff, frozen shoulder, jaw pain, headaches, bursitis, sciatica, patellofemoral syndrome, IT band syndrome, any type of strain, chronic pain (pain that lasts longer than 6 months), etc.