Soft Tissue Therapy

Dry needling treats muscle tissue, and its goal is to reduce pain, inactivate trigger points and restore function. Dry needling, sometimes referred to as ‘clinical or Western acupuncture,’ is an invasive method whereby solid filament (acupuncture) needles are introduced into the skin and tissues below, with the term ‘dry needling’ coined to differentiate it from ‘injection needling’ where something is injected into tissue with a hyperdermic syringe.

Dry needling is a unique procedure intended to specifically target and restore muscle function, with an emphasis on improving tissue healing and restoring normal tissue function. This is important as continued activity with poor muscle function may lead to further tissue damage and increased pain. Dry needling is not meant to replace conventional medical procedures such as physiotherapy or surgery. However, when combined with conventional treatment options, dry needling can be an influential method to accelerate pain reduction, healing and the restoration of normal tissue function.

The exact mechanisms of dry needling are complex and not fully known. However, there is a growing body of scientific evidence that supports the positive effect inserting a needle has on the electrical and chemical communications that take place in our nervous system. These include inhibiting the transmission of pain signals in our spinal cord and increasing the release of our own pain relieving chemicals within our brains. The pain relieving effect of dry needling is gaining strong support in mainstream Western medicine, with public hospital systems now directly funding its use.

There are obvious similarities between dry needling and acupuncture in that the needles used are identical. Generally dry needling is based on Western anatomical and neurophysiological principles, which are not to be confused with the Traditional Chinese Medicine (TCM) technique of acupuncture.

TCM is based on the use of “pulses,” “coatings” and “meridians” (or channels) derived from ancient Chinese philosophy and culture, with traditional acupuncture needles inserted into defined acupoints, intended to unblock energy meridians and help create balance within bodily systems. Advocates of traditional acupuncture promote its use for treating a range of physical and psychological problems.

Unlike the specific tissue targets used in dry needling, acupoints do not necessarily match our understanding of anatomy and the proposed treatment mechanism is largely inconsistent with modern medical science.

As I mentioned previously, the exact mechanisms of dry needling are complex and not fully known. However, there is a growing body of scientific evidence that supports the positive effect inserting a needle has on the electrical and chemical communications that take place in our nervous system. These include inhibiting the transmission of pain signals in our spinal cord and increasing the release of our own pain relieving chemicals within our brains.

Dry needling uses a very fine, solid filament needle to cause a small, precise injury or “lesion” in the tissue when it enters the body. The tiny needle induces injury signals the brain uses to initiate a sequence of events to replace or repair the damaged tissue with new, healthy tissue. Needling in a painful ‘trigger point’ ormuscular knot frequently provokes a “twitch” response from the muscle. This is both diagnostic as well as therapeutic, because healthy muscle tissue will not “twitch” when stimulated by the needle. Once a “twitch” response has been elicited, the muscle fibers in that area relax, ‘inflammation’ is reduced and circulation improves. As a result of these physiologic processes, dry needling can purposely address muscle, tendon and myofascial pain and dysfunction.

Personally, I feel dry needling has a complex effect on the body’s fascial make-up: with fascia being the connective tissue that surrounds muscles and joints, and keeps everything together. Originally fascia was thought to be an innate substance with minimal neural input/output, but on-going research has found that fascia is a highly innervated tissue (lots of nerves), and therefore would have a strong response to a slightly invasive treatment technique – such as dry needling.

Generally, needle insertion is not felt; the local twitch response or sudden slight contraction of the muscle may provoke a very brief pain response. This has been described as an electric shock or a cramping sensation. A therapeutic response occurs with the elicitation of local twitch responses and that is a good and desirable reaction.

During treatment, and depending on the dry needling technique used, patients commonly experience heaviness in the limbs or a pleasant feeling or relaxation. Following this technique some muscle soreness may be felt up to 24-48 hrs. The application of heat or ice depending of the needling site and drinking plenty of fluids usually reduces the soreness.

Dry needling is the modality of choice when it comes to treating acute injuries, muscle spasms or muscle pattern imbalances. It is very common to initiate dry needling at the beginning of your treatment program in order to break the pain cycle. Once that is achieved, other treatment options are introduced.

Typically, it takes several visits for a positive reaction to take place, as the needling is looking to cause mechanical and biochemical changes without any pharmacological means.  herefore, we are looking for a cumulative response to achieve a certain threshold after which the pain cycle is disturbed.

While dry needling can be very useful in relieving pain it does not necessarily address the source of the pain. For example, someone with advanced osteoarthritis of the hip or knee may have associated secondary muscular pain as the muscles compensate to avoid movement related with pain. Dry needling can be valuable in relieving the pain but it will not reverse the osteoarthritic alterations in the hip that are the source of the muscular pain.

The benefits of Dry Needling frequently include more than just relief from a particular condition. Many people find that it can also lead to increased energy levels, better appetite and sleep as well as an enhanced sense of overall wellbeing.

Graston Technique is a unique, evidence-based form of instrument-assisted soft tissue mobilization that enables clinicians to effectively and efficiently address soft tissue lesions and fascial restrictions resulting in improved patient outcomes. Graston Technique uses specially designed stainless steel instruments with unique treatment edges and angles to deliver an effective means of manual therapy. The use of GT instruments, when combined with appropriate therapeutic exercise, leads to the restoration of pain-free movement and function. The instruments also are used diagnostically to assess the kinetic chain, in an efficient manner using the principles of regional interdependence.