If the thought of lying on a table and being poked by tiny needles makes you feel uneasy, you’re not alone. But a growing number of people — from athletes to people with injuries or chronic pain — swear by its ability to provide sweet relief for intense muscle pain and mobility issues.
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Dry needling trigger point therapy has been used for decades, but it’s become an increasingly popular drug-free way to treat musculoskeletal pain.
It’s almost always used as part of a larger pain management plan that could include exercise, stretching, massage and other techniques, says clinical rehabilitation manager Adam Kimberly, PT, DPT, OCS. But it can play an important role in muscle recovery and pain relief.
How does dry needling work? It uses thin, dry needles — “dry” in the sense that they don’t inject anything into the body — that are inserted through the skin into the muscle tissue.
“Our main focus is muscle and connective tissue and trying to restore mobility,” he says.
It is performed by some physical therapists, acupuncturists, chiropractors or medical doctors who receive training in the technique.
When they’re overused or strained, muscles can develop knotted areas called myofascial trigger points that are irritable and cause pain.
“An overused muscle undergoes an energy crisis where, because of prolonged or inappropriate contraction, the muscle fibers are no longer getting adequate blood supply,” he says. “If it’s not getting that normal blood supply, it’s not getting the oxygen and nutrients that will allow the muscle to go back to its normal resting state.”
The tissue near the trigger point becomes more acidic, and the nerves are sensitized, which makes the area sore or painful.
Stimulating a trigger point with a needle helps draw normal blood supply back to flush out the area and release the tension, Kimberly says. The prick sensation can also fire off nerve fibers that stimulate the brain to release endorphins — the body’s own “homemade pain medication.”
To locate a patient’s trigger points, a therapist palpates the area with his or her hands. A trigger point map that notes common places in the body where trigger points emerge can be helpful, but every patient is a little different. “That’s where the clinician skill comes in — to palpate the area and locate the trigger point,” Kimberly says.
Once a trigger point is located, the therapist inserts a needle through the skin directly into it. They might move the needle around a bit to try to elicit what’s called a local twitch response, which is a quick spasm of the muscle. This reaction can actually be a good sign that the muscle is reacting.
Some patients feel improvement in their pain and mobility almost immediately after a dry needling session, Kimberly says. For others, it takes more than one session.
Regardless, it’s important to continue to keep the affected muscles loose by continuing to move them within their new range of motion after treatment, he adds. There can be some soreness for 24 to 48 hours afterward.
Is it right for you?
Your provider can advise you on whether dry needling could be a helpful addition to your treatment plan for muscle recovery, mobility issues, or acute or chronic pain.
“Needling is just a component of the therapy process,” Kimberly says. “It’s not everything, and it’s not the be-all, end-all for everyone.”