What is all this about dry needling(DN)? How long has it been around and how does it work? We asked the same questions when we became exposed to it back in 2008. After becoming certified in this procedure, we have seen very positive results utilizing this in conjunction with other treatment techniques in managing and treating many maladies.
Actually Dr. Janet Travell, MD started the concept of myofascial trigger points(TP) with David Simmons, MD and Lois Simmons, PT back in 19831. She took a lot of heat from the very beginning because this was a new concept and we did not have the ability to “see” myofascial trigger points with our diagnostic tests at that time. Today, we have the capability to see them and there have been a lot of studies done to support the use of this procedure.
Dr. Travell also started the concept of myofascial trigger point injections with a local anesthetic. Comparing this to DN, it was found to have an equal effect as long as the needle elicits local twitch responses (LTS)2. OK but is this like acupuncture? Both acupuncture and DN use a solid filament needle but their similarities stop there. Our philosophy and goals are quite different and the use of the needle is also different.
All of the physical therapists at Appalachian Physical Therapy (APT) have experienced many DN sessions during their training. I will tell you personally it is not the most comfortable procedure I have experienced, however, it is far from the worst. The benefits far outweigh the discomfort and I have come to appreciate these benefits personally. In fact, DN is usually on the short list of items I want performed first when I am injured. It allows us to usually shorten the time needed to get patients better. Fewer visits mean more time doing the things you enjoy doing with lowered costs in the long run. That is exactly why we suggest the use of DN when we feel it is appropriate.
A case in point (there I go again) was a patient that was here for a shoulder injury he received while picking up a metal grate. I began treating him with manual soft tissue work while waiting to get an authorization for DN from his referral source. After receiving the authorization, I felt he could still benefit from DN and believed it would hasten his recovery. The results speak for themselves. I needled two muscles in his shoulder region reducing his pain and discomfort to a minimal level. Upon returning for his next visit, I felt he was at a point of being able to handle this at home independently.
Rarely is DN used as a stand alone treatment and it should be remembered it is only one of many procedures we use to help a patient get back to their normal activities with less pain. The first class taught to physical therapist in the United States on DN was done in/around 1999 so it has been in this country for almost two decades. In Virginia we need a referral from your physician, physician’s assistant, nurse practitioner, dentist or chiropractor specifying DN. One thing you can depend on when receiving care at APT is the continued pursuit of improving care we give patients at our facilities. We are always evaluating cutting edge treatment techniques as well as pursuing further education with the goal of providing you, the patient, the best care available.
Call or contact us today to see if DN is appropriate for your care.
- Simmons, MD, David, Lois S. Simmons, PT, Travell, Janet G., MD; Myofascial Pain and Dysfunction The Trigger Point Manual, Volumn 1. Upper Half of the Body. Lippincott Williams and Wilkins 1983.
- Hong CZ: Lidocaine injection verses dry needling to myofascial trigger point: the importance of the local twitch response. Am Journal Phys Med Rehabilitation 73:256-263, 1994