*"In this age of specialization, few clinicians are broad enough to see the whole patient and his/her problem." Janet G. Travell, MD (1901-1997)
*Travell, J, Simons, D. Myofascial Pain and Dysfunction: The Trigger Point Manual.Baltimore: Williams & Wilkins; 1983
What is Trigger Point Dry Needling (TDN)?
Trigger Point Dry Needling (TDN) is not acupuncture. TDN is a procedure in which a very fine monofilament needle is inserted into the skin and muscle directly at a myofascial trigger point to decrease pain. A myofascial trigger point consists of multiple contraction knots, which are related to the production and maintenance of the pain cycle. We at Progress Physical Therapy continually seek out advanced continuing education to learn the most cutting-edge and evidence-based techniques to comprehensively treat our patients to achieve the best possible results. TDN is an effective method for treating pain, but not everyone is aware of its use and not all Physical Therapists have completed the required training to perform this procedure.
What is a trigger point?
A trigger point is a small area of muscle that is in spasm (contracted), causing taut bands and hypersensitivity. These "knots" in the muscle cause a restriction of the blood supply, which reduces the amount of oxygen, leading to the accumulation of waste products and toxins. This accumulation sensitizes the trigger point, causing it to send out pain signals, which increase local and/or referred symptoms. Therefore, a trigger point involves a vicious repeating pain cycle that needs to be broken.
How does TDN work?
The exact mechanisms of dry needling are not known, but there are positive mechanical and biochemical effects, which assist in reducing pain. It is essential to elicit a "twitch response" which is a spinal cord reflex and is the first step in breaking the pain cycle.
What type of problems can be treated with TDN?
A variety of musculoskeletal problems can be treated with TDN. Such conditions include, but are not limited to, neck, back and shoulder pain, headaches, arm pain (including tennis elbow), hip, buttock and leg pain, jaw (TMD) pain, whiplash, and carpal tunnel syndrome. The treatment of muscles can have a profound effect on reducing pain mechanisms in the body.
Is TDN painful?
Most patients do not feel the insertion of the needle. The local twitch response elicits a very brief painful response. Some patients compare it to a mild electric shock; others feel it more like a cramping sensation. The therapeutic response occurs when there is a local twitch reaction.
How long does it take for TDN to work?
The time it takes to notice an improvement is variable. Typically, it takes several treatment visits for a positive reaction to take place, especially if the condition is chronic. Your Physical Therapist will set up a treatment plan based on your clinical presentation. We are looking for a cumulative response to achieve a certain threshold after which the pain cycle is broken and you begin to experience relief. Usually, the best results are achieved by combining TDN with other Physical Therapy treatments.
Do I need a prescription from my Physician?
You do need a prescription from your Physician to be treated with TDN. We are happy to discuss this treatment option with your referring Physician if he/she has any questions.
How often do I need to come back to maintain my progress?
The musculoskeletal system is under constant pressure from gravity, stress, work, etc. A regular exercise program, prescribed by your Physical Therapist, which addresses muscle imbalances and maintains normal joint mobility combined with good posture and body mechanics can prevent the recurrence of many problems. If the pain returns, you may need to return for additional TDN and/or progression of other Physical Therapy treatments.
We look forward to serving you in this way at Progress Physical Therapy!
Progress Physical Therapy, LLC
5300 Hickory Park Dr., Suite 110, Glen Allen, VA 23059