Dry Needling Therapy
Dry needling is a skilled intervention performed by a certified healthcare provider to decrease pain and tightness associated with myofascial trigger points - think painful muscle knots. A thin filiform needle is inserted into the involved trigger point which creates a cascade of events that lead to decreased pain, increased range of motion, and improved strength.
I have extensive training in trigger point dry needling. As an instructor with the first and original dry needling education company, Myopain Seminars, I have helped PTs throughout the country learn the technique. Additionally, I am a co-author of the myofascial pain chapter in Goodman and Fuller's "Pathology: Implications for the Physical Therapist".
I have helped many patients that have had dry needling at other clinics with limited results. This is primarily due to having the skill and knowledge to be intentional with the dry needling treatment. Many providers go directly to the source of pain without examining other contributing muscles. For instance, did you know that the treatment of the triceps can help alleviate many cases of golfers and tennis elbow? Furthermore, having a successful outcome with dry needling is dependent on specificity. Many of my patients feel I am the first provider to reproduce or reach their area of pain.
Dry needling is an effective way to decrease muscle pain and tightness for a variety of diagnoses for:
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Headaches
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TMJ
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Back Pain
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Neck Pain
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Rotator Cuff Injuries
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Pelvic Pain
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Hip and Shoulder Labral Tears
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Tennis Elbow
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Frozen Shoulder
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Tendinitis/Bursitis
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Sciatica
Why is dry needling so effective? There are four main reasons:
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Blood Flow: Studies have shown that dry needling can improve the local blood flow of trigger points treated. This is important because decreased blood flow is associated with increases in chemicals that can lead to further muscle pain and tightness.
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PH: With improved blood flow comes improved PH. A decrease in PH (acidic) is associated with an irritated and sensitive muscle (think lemon juice in a wound!). Dry needling has been shown to make the local area less acidic and overall healthier muscle tissue.
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Neuroinflammation: Trigger points contain neuropeptides and cytokines that increase the sensitivity of our nervous system. Dry needling can decrease these chemicals which can improve local tenderness and associated pain.
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Electrical Activity: Dry needling is very effective at providing a "reset" to the muscle. This is accomplished by altering the electrical activity that is occurring at the neuromuscular junction (the area where nerve and muscle meet).
Ultrasound-Guided Dry Needling: Treatment for Plantar Fasciitis
Plantar foot pain (heel pain) is a common complaint I see in the clinic. Unfortunately for some, it can be persistent and chronic. In some cases, it can severely limit functional activities including walking, running, and recreational sports/exercise. While the common diagnosis is plantar fasciitis, there are other potential causes of heel pain including:
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Referred pain from tight calves (and other muscles of the posterior lower leg)
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Plantar Nerve Entrapment
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Referred back from the lower back
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Fat Pad Syndrome
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Tendinopathy of small muscles in the foot
However, there are other times when in fact someone may have true plantar fasciitis. In addition to the hallmark sign of morning pain (first few steps out of bed), a positive diagnosis will depend on a proper diagnostic ultrasound. The ultrasound's plantar fascia thickening and abnormal collagen appearance will confirm this diagnosis. In these cases, the use of ultrasound-guided dry needling may be an adjunct treatment. Performing dry needling in the area of abnormal collagen can help stimulate the production of healthier and more robust collagen. This can then be followed up with an appropriate progressive strengthening program to allow for a return to activities.
