Dry needling is commonly used in the treatment of pain related to chronic musculoskeletal disorders.
This method is called dry needle treatment or dry needling because no medication is administered and no injection is done. Very thin needles with different lengths and diameters are inserted in the painful and contracted muscles. The alleviation of the cramp with this technique is the base of the treatment. The resolution of the muscle cramps may alleviate the pain related to the cervical and lumbar disc hernia. Non-surgical methods may provide satisfying solutions in the majority of the patients. The dry needle treatment is commonly used by the physiatrist s for the treatment of pain caused by the muscle cramps.
WHAT IS TRIGGER POINT?
The muscle bundles, which become stiff and tight within a big muscle mass of the skeletal muscles, are called trigger points. The trigger points are painful to palpation. The pressure applied to a trigger point may cause pain in other regions of the body. For example, if one trigger point in the medial border of the scapula is stimulated with palpation, the pain may spread to the neck and arm. The trigger points are responsible for the majority of the muscle pains. The dry needling is an effective method regarding the treatment of the trigger points.
HOW DRY NEEDLING IS APPLIED?
The main goal of the dry needling is to relax the cramped and shortened muscle along with the alleviation of the pain. Although the needles are different, dry needling is a very similar method to acupuncture. However, acupuncture originates from ancient Chinese medicine and dry needling is a method of Western medicine. During this treatment, the number of sessions may depend on the severity and duration of the disease, which are determined by the physiatrist during the examination.
After the determination of the trigger points with the physical examination and appropriate cleaning of the application site, the needles are inserted through the skin into the targeted muscle tissue. The needles are sterile and disposable. Superficial or deep applications are possible. In the superficial method, the needle is inserted until the subdermal tissue and deeper applications are avoided. This technique is usually sufficient for the uncomplicated trigger points. There is almost no risk of nerve, vessel, or visceral organ injury.
Another technique is deep dry needling. It is useful in the treatment of the complicated muscle cramps related to the nerve root compression due to the lumbar and cervical disc hernia together with trigger points. During the deep needling, the needle is inserted deep in the muscle and then it is withdrawn until the connective tissue surrounding the muscle and inserted again in the muscle. During this dynamic technique, a muscle response consisting of local muscle fasciculation is invoked. Sometimes the needle let in the muscle for a predetermined time (static technique). The needle may be rotated a few times throughout this waiting time in order to ensure traction in the smoot tissues. Thus, the myofascial trigger points, muscle, and connective tissues are stimulated. The waiting time is between 10 and 30 minutes. In a dry needling session, tens of needles may be used depending on the affected muscle tissue. The treatment is planned as 3-6 sessions (1-2 session per week). The patients feel positive effects even after the first session.
WHICH DISEASES CAN BE TREATED WITH DRY NEEDLING?
Dry needling is a common practice in pains related to the myofascial pain syndrome, head, neck, back and lumbar areas and postural disorders caused by muscle cramps. In patients with lumbar and cervical disc hernia, dry needling contributes to the primary treatments with the resolution of the cramp-related component of the pain. In addition to the dry needling treatment, physiotherapy and exercises may increase the chance of recovery.
WHO ARE NOT SUITABLE FOR DRY NEEDLING?
In patients, who have needle phobia or refuse this treatment, dry needling should be avoided. The deep dry needling should not be applied in patients, who use anticoagulant agents and have a coagulation disorder (e.g. hemophilia). In patients with lymphedema (patients, who have edema in legs or arms due to the removal of the lymph nodes during the cancer treatment), dry needling should not be applied to the edematous extremities.
WHAT ARE THE RISKS OF DRY NEEDLING?
As no medication is administered, there is no risk of side effects related to the drugs. However, low risks of pleural or pulmonary damage, vascular or neural injury should be considered especially during deep needling. As the physiotherapy and rehabilitation specialists have a good knowledge of human anatomy, the possibility of these risks is negligible during the dry needling.