Dry needling is a tool used by physical and manual therapists such as Myotherapists, as an intervention to treat musculoskeletal dysfunction and pain.
Myofascial trigger points are taut bands which develop within the muscle and are associated with muscular referral pain and dysfunction. The taut bands develop due to the lack of release of a chemical called acetylcholine at the motor end plate; the muscle fibres become shortened, and sustained in a contracted position. Increased levels of nociceptive chemicals, “pain chemicals” contribute to the sensitisation of muscle, which also leads to a reduction in blood flow and oxygen to the muscle along with other nutrients which are needed for muscle relaxation.
During myofascial dry needling, the needle is tapped into the subcutaneous layer of the skin, touching sensitive nerve endings and neural tissues. The needle stimulates connective tissues, taut bands within the muscle and myofascial trigger points (MTP). This is particularly helpful for the deactivation of myofascial trigger points to manage short and long term pain.
The physiological effects of dry needling are one which interrupts the electrical activity by eliciting a twitch response, reducing the sustained contraction which has led to the development of the trigger point.
At a local level, the needling encourages vasodilation, prolonging small amounts of bleeding within and around the muscle; this reabsorption of new blood helps promote the rebuilding of the surrounding tissues- a self-healing process of the body. This can stimulate the inflammatory response and speed up the recovery process. Healthy immune cells such as phagocytes are encouraged to the area, bringing leukocytes which also removed debris. Along with this, macrophages are released as a response to the micro damage to the tissue by the needle, producing mediators which stimulate the physiological stages of healing.
Trigger points can also induce a peripheral source of local and widespread pain, eg. a trigger point may be irritated in a muscle within the gluteal muscle but be sending pain signals all the way down the leg. The referral signals result in continuous pain stimuli being sent to the muscle, and therefore back towards the brain, without the pain receptors actually being stimulated. When dry needling a twitch response may occur, which activates A-fibres and C-fibres which can lead to inhibition of the spinal cord, blocking the transmission and interrupting these pain signals, this decreases pain and desensitises the nervous system.
The endogenous opioid system is thought to be triggered when dry needling, and is useful for pain modulation, releasing across the peripheral and central nervous system blocking nociceptors and initiating an analgesic effect.
If you have any further questions about myofascial dry needling and how it can help your aches and pains please feel free to contact one of our Myotherapists to discuss your case.
Leah Rampling – Elite Myotherapist