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Nagging Muscles and Niggling Pain

Dry needling rescue

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Nagging Muscles and Niggling Pain

Dry needling involves inserting needles into trigger points in muscles. It provides pain relief for muscle knots, headaches, and joint and muscle pain.

Waking up, your back is killing you. You are convinced you must have broken a vertebra. Groaning, you all but stagger out of bed. You can hardly move, and putting your socks on is out of the question. What on earth are you going to do?

Perhaps you put up with this dreadful pain for some time, but in the end you drag your sorry body to the health practitioner. An examination followed by a series of tests and then you hear the dreaded truth?it’s just muscle.”

You can’t believe it. Muscles can’t hurt this much—can they?

Mighty painful muscles

But, wait a minute—who hasn’t endured the absolute agony of a charley horse, or the almost unbearable pain of night cramps? Muscles can and do hurt—a lot! Sadly though, sore muscles don’t get much respect.

Far too often we put up with muscle pain because we don’t know what else to do. Once a muscle starts hurting, our body subconsciously protects it. This leads to other muscles overworking or stretching inappropriately to limit the current pain, only to cause ourselves referred pain. So what can you do to naturally heal a sore back/leg/neck/arm that is only muscle?

Enter dry needling

If you haven’t heard about this great alternative treatment, you are not alone. However, as early as 1944, Dr. O. Steinbrocker published research findings on dry needling in the Journal of the American Medical Association.

Although dry needling, often referred to as trigger point dry needling (TrP-DN) or intramuscular stimulation (IMS), is currently practised throughout Europe, the United States, China, and Japan, in Canada it is not as well known as acupuncture, from which it takes its lead.

Dry needling is practised by physical therapists or acupuncturists, depending on local regulations. Both types of practitioners need added specific training before they can practice dry needling.

How does dry needling work?

Writing in Canadian Chiropractor recently, Tracey Teasdale BSc (Hons), ND, who received the 2008 SIRC Research Development Award for her work on dry needling for athletes, explains how dry needling works.

Acupuncture needles have an analgesic effect, altering the spinal cord pathways for pain, releasing endorphins, and inhibiting pain receptors. Inserting a needle directly into the [myofascial] mechanically breaks up the tender spots through a series of “micro-stretches,” decreasing the tension on capillaries and pain-sensitive structures. A needle alters the circulation and metabolism, restoring normal function to the tissue.

The needle used in this modality is the same used by acupuncturists, and there is very little, if any, sensation as it enters the skin. The practitioner inserts the needle into the tight band of muscle that is causing the patient pain. As the needle is manipulated, the muscle fibres fire around the needle and the patient may experience a feeling just like cramping. As the needle is withdrawn, the muscle relaxes and the pain is released.

What to expect at your first appointment

Your first appointment will likely be between 90 minutes and two hours; subsequent visits are normally between 45 minutes and an hour. Make sure you arrive 10 minutes early, as you will have several forms to complete once you arrive.

These forms include a complete medical history and may also include your current conditions/symptoms, treatment goals, current exercise regimen, and sleeping habits.

You’ll then meet with your practitioner to discuss your medical history and address any questions or concerns you may have about your conditions/symptoms or about the treatment itself. Afterward, your practitioner will likely do a postural assessment on you, for which you may have to disrobe down to your undergarments. If you feel more comfortable doing so, wear a bathing suit under your clothing.

Once you and your practitioner have discussed your medical history and your conditions/symptoms and after the assessment, you will begin your treatment, which will be different for each individual’s needs.

Your first appointment will involve a lot of talking so that your practitioner can get a thorough understanding of your pain and how to best treat it. It’s important that you trust your practitioner, and if you are at all uncomfortable throughout the session, speak up. If your feedback is not taken into consideration then that’s a good sign you need to find someone else.

What about side effects?

According to John Howick, BScPT, FCAMT, physiotherapist and owner of the Kamloops Physiotherapy and Sports Injury Centre, after a session of dry needling it is common for the patient to experience aches or fatigue in the needled muscles. Often described as feeling like they had a very deep massage or an intense bout of exercise, patients report the effect usually lasts two to 12 hours, but it may last for two to three days.

In rare cases, usually when patients’ muscles and nerves are hypersensitive, they may experience discomfort for up to a week. This is quite unusual and often a good indication that they are not a good candidate for dry needling. Such patients may respond better to acupuncture, which is less intense.

The positive effects of dry needling include increased flexibility and significant pain relief. When used in conjunction with other treatments, such as exercise and postural correction, the improvement is ongoing, and function is restored for long periods of time.

This isn’t a magic cure mind you. It often takes several sessions and a good exercise regimen for full effect, but the relief is wonderful and long lasting—and it sure beats getting up in the morning groaning as if a vertebra had broken.

Dry needling versus acupuncture

Dry needling

Both

Acupuncture

  • points of insertion are selected by the practitioner feeling where the trigger points are
  • needles are inserted and quickly manipulated before being removed shortly after (within three minutes)
  • practitioners use knowledge of how the body moves to find trigger points in other muscles contributing to the pain area
  • conditions that respond to dry needling include muscle knots; neck, back, leg, and arm muscle pain; headaches; joint pain; musculoskeletal pain
  • up to 76 percent of trigger points correspond with acupuncture meridians
  • use the same needles, though gauge may vary depending on where they are being used on the body
  • points of insertion are based on traditional Chinese medicine principles of meridians and chi, as well as knowledge of human anatomy
  • needles are inserted and typically left in for 15 to 30 minutes before being removed
  • points of insertion may be far away from pain area; for example, the point in the web space between the thumb and index finger is used to treat headaches
  • may apply heat or mild electric pulse to needles
  • conditions that respond to acupuncture include chemo-induced nausea, fibromyalgia, headaches, labour pain, lower back pain, menstrual cramps, migraines, osteoarthritis
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