What is Dry Needling?
Many people are familiar with the term ‘dry needling’, in fact – many people (athletes in particular) may have had dry needling performed on them. Despite the growing popularity of this treatment there still remains a lot of misunderstanding about how it actually works, and how it differs from acupuncture.
Acupuncture is a traditional Chinese medicine treatment, used to insert needles in various ‘acupoints’ throughout the body. This is done with the intention to restore the flow of energy (Qi) that flows within channels (meridians) running throughout the body. Although using the same needle as in acupuncture, dry needling is vastly different in its intended purpose and desired outcome.
Dry needling is a technique used to treat muscular and myofascial pain that may develop from an array of different causes, one of these being the response to high physical demand placed on the muscle’s fascia and tendons.
Myofascial pain syndrome (MPS) is a broad term used to describe pain and discomfort felt as a result of changes within the muscle and skeletal tissues. ‘Myo’, a term meaning muscle and ‘fascia’ meaning the tissues that surround each muscle, make up this term. The development of MPS is often caused by changes in these tissues through the presence of myofascial trigger points (TrPs) that may develop within the muscle fibres. Otherwise referred to as ‘muscle knots’, myofascial trigger points are hyperirritable and highly sensitive areas within muscle and fascia. These points are categorised by having palpable taut bands of muscle fibres that elicit both local and referred pain, particularly when pressure is applied to the area. These areas may also present as ‘nodules’ within the muscles, which are easy to identify when feeling throughout the muscle.
As previously discussed, MPS may not be solely due to sport or exercise. Similarly, the development of myofascial trigger points may occur for various reasons, however, mechanical muscle overuse is the most common cause, within sporting populations, as well as in response to injury. With high training loads and large demands placed on myofascial tissues, working muscles are often brought to high levels of fatigue. Muscles require energy (ATP) to function, and with high physical demand, ATP levels may deplete as the muscle fatigues allowing bi-products to accumulate within the muscle. Many chemical processes are happening as a muscle fatigues and this process is thought to be the main factor in the development of MPS and the development of myofascial trigger points in athletes.
In order to prevent any ongoing stress on muscle tissues, and improve training and performance, ‘dry needling’ is a technique commonly used to treat MPS. Dry needling involves the insertion of an acupuncture needle to desensitise any active myofascial trigger points.
When performing dry needling the desire is to produce a ‘local twitch response’ within the muscle and its trigger point. Accurate palpation of the muscle needs to be used to identify any active trigger points before inserting an acupuncture into this point. The insertion of the needle into this point causes a contract-relax response of the muscle. Insertion into this point is likely to cause some referral pain to surrounding areas of the body. Stimulating a local twitch response causes nerve cells to fire rapidly, which alters the chemical concentration of the trigger point, allowing relaxation of the taut muscle bands and desensitising the area.
NB: Although typically not painful, dry needling may bring about a dull ache in the muscle following treatment. This ache typically resolves in the hours following but may remain for 24-48 hours. Sporting performance has been shown to improve 48 hours following dry needling treatment, so deciding when to have dry needling done is important so that competition and training performance can be optimised.
Bron, C., & Dommerholt, J. D. (2012). Etiology of Myofascial Trigger Points. Current Pain and Headache Reports, 439 – 444.
Devereux, F., O’Rourke, B., Byrne, B., Byrne, S., & Kinsella, S. (2018). The Effects of Myofascial Trigger Point Release on the Power and Force Production in the Lower Limb Kinetic Chain. Journal of Strength and Conditioning Research.