August 28, 2017

Trigger point dry needling: On-point pain relief

Sometimes all it takes is the prick of a small needle to ease a painful, knotted muscle that has stubbornly resisted other forms of treatment. That’s one reason why a technique called trigger point dry needling is becoming more popular as a complement to physical therapy.

The approach involves inserting a needle directly into muscle tissue, zeroing in on the trigger points that can cause pain in your muscles, tendons or joints.

“When you get a taut band, your muscle is not relaxing and contracting as it should be, and it causes a knot, or trigger point. When you push on those trigger points, it can refer pain elsewhere,” said Liz Chumanov, DPT, PhD, a physical therapist at the UW Health Sports Rehabilitation Clinic who is trained in the technique.

“What the needle is doing is allowing you to get directly at that spot — it’s going to disrupt that taut band and cause it to relax. It’s going to cause a little bit of tissue damage, which is actually a good thing because it will cause more blood to flow to the area, and blood flow is very healing. It can also have a quieting effect on the nerves.”

Chumanov has used dry needling to treat headaches, shoulder pain, mid-back pain, foot pain and more. “It really is beneficial for a wide variety of diagnoses,” she said. “If you can locate areas that are really tight or tender in a muscle, or if you’ve been working with physical therapy and getting results, but the results are just not lasting, then you’re a very good candidate for dry needling. It can really make a difference.”

Things to know about trigger roint dry needling

Here are some other points to know about trigger point dry needling:

It’s not acupuncture. “Dry needling is very different from acupuncture,” Chumanov said. “Acupuncture is a Chinese medicine technique based on the movement of qi and the flow of it in your body. We’re more focused on myofascial pain. So the insertion of the needle is very similar, but the philosophy is very different.”

It’s quick. The physical therapist will identify the trigger points causing your pain and then gently manipulate a needle at the site until there’s a twitch response, indicating that the muscle knot has released. “We’re probably in no more than 30 seconds,” Chumanov said.

It may or may not hurt. “Everybody is different. For some people if feels like a tickle, others may find it intensely painful,” she said. “What happens afterward is that most people will get muscle soreness, like they worked out, and then the soreness will clear up after one to two days.”

There’s some research to back it up. A 2013 report in the Journal of Orthopaedic and Sports Physical Therapy found that dry needling can reduce myofascial pain. “The research on dry needling is really in its infancy,” Chumanov said. “The biochemical nature of it has been proven well, but there’s still a lot more research to be done. We need to go back to see how it works in very specific muscles.”

There are some risks. There is a small risk of puncturing a lung when using a needle over the rib cage, but a physical therapist who is trained in the technique will know how to minimize the risk. Patients who are on blood thinners should also be cautious and should consult their physician before trying dry needling.

It may take more than one session. Depending on the severity of your muscle tightness, you might need two to four sessions spaced one to two weeks apart to get lasting relief.

It’s only one part of therapy. “We’re not using this treatment in isolation,” Chumanov said. “We use it to augment physical therapy — we’re trying to make a meaningful change in the muscle tissue so patients can be more effective with their home programs or movement patterns.”

Ready to give it a try? Learn about trigger point dry needling at UW Health