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Biology of Dry Needling

Dry needling, which is different from acupuncture, is one of the only invasive methods that physical therapist can deploy to alleviate patient’s symptoms. Tight muscular knots or “trigger points,” occur within muscles, which can cause localized pain in the specific area, or diffuse pain down the extremity. There are many reasons why a trigger point can develop, such as previous surgery, bracing, stress, or sustained postures at work or with life activties. A trigger point, or taut band, causes decreased oxygenation to the muscle, which in turn causes the muscle to have a lower pH and become more acidic. Not only do muscles with trigger points become more acidic, but they also do not fire as efficiently, which causes active movements to feel weaker and less comfortable. Dry needlng to a specific trigger point can release the tight band within the muscle, which will promote oxygenation, increase pH, make the muscle less acidic, and faciliate more efficient muscular firing and activation, which allows people to move more easily and with less pain. Ultimately, trigger point release via dry needling can have immediate, profound effects that can promote one’s ROM, muscular activation, and decrease their nagging symptoms.

How does a physical therapist find a trigger point and perform dry needling? Well firstly, the physical therapsit will perform an initial evaluation and take a patient history to determine if dry needling is appropriate and would be beneficial. Once dry needling is deemed safe, appropriate, and useful, the physical therapist will know which muscles to target based on the subjective reporting from the patient/client. Next, a tight band is identified by the therapist’s hands, and a thin needle will be inserted into the area, staying awaying from the lung fields, cardiac, and neurological tissue. If the right trigger point is hit, the entire muscle belly will twitch, which is expected. The needle will then be strummed until the muscle stops twitching. As the muscle twitches it releases acidic properties from the tight area, which causes residual muscle soreness for the next 1-2 days but effectively treats the area and improves symptoms. Some may experience lacrimination (tear from eyes) or sweating while receving trigger point release, which is not uncommon. After a round of dry needling, most physical therapists encourage more medicinal movements and exercises to decrease delayed onset muscle soreness.

Dry needling can be performed immediately to address soreness and tightness mid-competition (golf, tennis, ect), but it can also be used to address more chronic tightness and pain, that some may experience from prolonged slouching at a desk. As always, reach out to your local physical therapist or primary care doctor to understand if your symptoms can be addressed with dry needling. To summarize, tight knots or trigger points develop within muscles, which causes decreased blood flow, decreased pH, and increased acidic properities and symptoms. Trigger point release via dry needling promotes blood flow to tight muscular area, which causes increased pH and less acidic properties to the muscle, with the goal of increasing muscular activation, ROM, symptom management, and particpation in life activites.


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