Dry Needling: What it is and why we do it
Why is Dry Needling a Common Treatment Technique at Landreneau Physio?
Let me take you back approximately two and a half years ago when my husband, Dr. Kevin Landreneau, had his first meaningful experience with dry needling. It was January 2017, and we were taking the first of two dry needling courses offered by the Dry Needling Institute founded by fellow Physical Therapist and Osteopractic pioneer, Dr. James Dunning. For those of you that don’t know, Kevin has suffered from chronic neck pain and headaches ever since he accidentally dove into the shallow end of a pool in his early 20’s. Prior to this course Kevin had managed his pain enough to function but the nagging pain never really went away. His pain was greatly reduced when he was manipulated by Dr. Dunning at a previous course which covered spinal thrust manipulations (AKA adjustments) , but, he continued to struggle with headaches and occasional neck symptoms. That all changed after we attended our first course on dry needling. One session of dry needling to his neck and head and he felt relief like he had never known. Just like that our professional trajectory changed. Our days of helping people manage their pain was over. We are now dedicated to helping people find permanent relief of their symptoms by providing them with treatment techniques that are CORRECTIVE and not just ways to manage or temporarily relieve their symptoms.
What Is Dry Needling?
Dry needling is best defined as a technique used by physical therapists where a “dry” needle (dry meaning without medication) is inserted through the skin and into areas of the muscle with the purpose of releasing a trigger point in that muscle. In order to better understand dry needling, and how relieving trigger points with a needle can greatly relieve pain and restore motion, I must first explain what a trigger point is and how trigger points located throughout the body can cause pain and dysfunction in the first place.
What is a Trigger Point?
A trigger point is defined as a tender spot (nodule) within a taut band of muscle that elicits pain when pressure is applied to its location. The pain is often referred pain, meaning that when pressure is applied to the trigger point the pain shoots into a location other than where the point is located. Another common response elicited when a trigger point is palpated is what is called a “twitch response” which is a quick, involuntary contraction of that taut band of muscle.
Trigger points are a result of muscular injuries either through micro trauma (overuse injuries) to the muscle tissue or through a previous traumatic injury to the muscle or local joint. Tiny tears in the soft tissue occur whenever muscle fibers, fascia, ligaments, or tendons become inflamed. When the tissue begins to heal these tiny tears it becomes contracted and twisted up forming a nodule within the otherwise smooth muscle tissue fibers. As a result, this nodule of knotted muscle fibers, becomes restricted of it’s blood supply and may also shorten in an attempt to protect itself from future injury.
What’s even more problematic about muscular trigger points is that, when left untreated, they begin to alter muscle firing patterns (the sequence in which your various muscles contract to perform a desired movement) and the result is movement compensation which often restricts range of motion and places unnecessary stress on the associated joints and ligaments. As you can expect, what was once a small and probably unnoticeable tissue injury is now a significant problem that is contributing to other injuries and nagging pains throughout the body.
How Does Dry Needling Work to Inactivate Trigger Points?
Now that you understand what trigger points are and why they are so problematic I can better explain the science behind dry needling. Dry needling was discovered accidentally by Dr. Janet Travell in the 1940’s when she discovered that the relief that she achieved using a “wet” needle (one with medicine) injected into a muscular trigger point was also achieved when she used a needle with no medicine, otherwise known as a “dry needle”. The two main principles behind why a dry needle inserted into a trigger point works to relieve the pain and restore movement are as follows:
Blood Flow - When the needle is inserted into the trigger point, a much needed supply of blood pools around the needle and supplies the tissue with fresh oxygen and nutrients which triggers the contracted muscle fibers to relax. This new supply of blood also allows for the flushing out of acidic chemicals and toxic build up that has been essentially “stuck” within trigger point due to a lack of blood flow. Now that the blood supply is restored to the damaged tissue this allows for a more optimal environment to promote proper healing.
The Endogenous Cannabinoid System - To put it simply, when the needle is inserted into the muscle tissue It triggers a response from the central nervous system (brain and spinal cord) which effects the bodies own pain-modulating system resulting in a local analgesic effect (pain relief). Research has also demonstrated that by applying electrical stimulation to the dry needles that are inserted into the trigger points this can actually double the opioid response compared to needling alone!
Does Dry Needling Work Alone?
DRY NEEDLING IS A TREATMENT TECHNIQUE THAT SHOULD BE USED IN CONJUNCTION WITH OTHER FORMS OF TREATMENT. No, I’m not yelling at you but I want everyone to know that dry needling works best in combination with other forms of treatment. To simply relieve trigger points via dry needling and then send you on your way would be unjust. These trigger points have likely been present for years resulting in significant joint mobility deficits, muscle firing dysfunction, movement compensations and surrounding tissue deficits that need to be addressed in order to prevent the pain from returning again. We use manual therapy techniques such as joint manipulation, prolonged tissue stretching, and exercise instruction to ensure that the best outcome is achieved. Movement needs to be restored and you need to learn to be conscious of how you move so you can self-identify when you are falling back into movement compensations that have developed over years of tissue malfunction. Mobility training needs to become a part of your daily routine to ensure that you are moving and functional at an optimal level in order to not pre-dispose yourself to future injuries.