Dry Needling

Dry needling is an invasive procedure where a fine needle or acupuncture needle is inserted into the skin and muscle. It is aimed at myofascial trigger points (MTrPs) which are hyper-irritable spots located in the taut band of the skeletal muscle and can be palpable as a nodule.

Pathophysiology of MTrPs

• Active trigger points can spontaneously trigger local or referred pain. They cause muscle weaknessand restricted range of motion (ROM).
• The formation of trigger points is caused by the creation of a taut band within the muscle. This band is caused by excessive acetylcholine release from the motor endplate combined with inhibition of acetylcholine esterase and upregulation of nicotinic acetylcholine receptors.
• Initially, taut bands are produced as a normal protective, physiological measure in the presence of actual or potential muscle damage. They are thought to occur in response to unaccustomed eccentric or concentric loading, sustained postures and repetitive low-load stress. However, when sustained they contribute to sustained pain.
• Pain caused by trigger points is due to hypoxia and decreased blood flow within the trigger point. This leads to a decreased pH which activates the muscle nociceptors to restore homeostasis. This causes a reduction in the threshold and/or an increase in  responsiveness at the peripheral ends of sensory nerve fibers.

Mechanisms of Action

Dry needling has been shown to immediately increase pressure pain threshold and range of motion, decrease muscle tone, and decrease pain in patients with musculoskeletal conditions. It’s suggested mechanisms of action include:

Local Twitch Response: Dry needling can elicit a ‘local twitch response’ which is an involuntary spinal reflex resulting in a localized contraction of the affected muscles that are being dry-needled. Local twitch response can lead to alteration in the length and tension of muscle fibres.

Effects on Blood Flow: Sustained contraction of taut muscle bands in trigger points might cause local ischemia and hypoxia. Dry needling causes vasodilation in the small blood vessels leading to increased muscle blood flow and oxygenation.

Neurophysiological effects: Dry needling may produce local and central nervous responses to restore homoeostasis at the site of the trigger point which results in a reduction in pain.

How is Dry Needling different to Chinese Acupuncture?

Acupunture works on traditional Chinese medicinal philosophies of meridians (or lines of energy) that create balance to bodily systems and organs.

Dry needling is based on a Western understanding of anatomy and muscle function.

This treatment is available and can be booked with Mikaela under an Exercise Science appointment or requested during a Massage appointment with Mikaela.