Dry Needling - IFC Physiotherapy Singapore

Dry needling, sometimes referred to as western acupuncture, is an evidence based, brilliantly effective solution to musculoskeletal pain.

Before I attempt to convince you that this is the best thing since sliced bread, I do want to make it very clear that I am not referring to traditional Chinese medicine (TCM), acupuncture. TCM views the body in a different way from western medicine, and often uses acupuncture to treat a variety of systemic illnesses that fall way outside of a physio’s scope of practise.

Disclaimer out the way, lets have a look at why you should consider letting me stick needles in you.

So first of all, what is dry needling?

Dry needling is defined as

‘the insertion of a solid filament needle into trigger points’

Ok, that’s all well and good, we’ve all heard of them, but what actually are trigger points?

Myofascial trigger points are tender areas within muscles that often feel like a hard bump. When palpated they can hurt and cause referred pain to other areas. If left untreated they can cause your muscles to become very tight, potentially restricting your movement.

What kind of conditions can dry needling help with?

Fortunately this treatment modality has a fairly sizable body of medical research behind it.

The most conclusive, high level body of evidence finds that dry needling is particularly effective for:

  • Chronic lower back pain (2)

Slightly lower quality, yet still relevant studies support the use of dry needling for:

  • Neck pain (4, 11)
  • Shoulder pain (4, 10, 12)
  • Knee osteoarthritis (8, 13)
  • Migraines and tension type headaches (1, 5, 6, 9)
  • Tight and/or painful muscles (3)
  • Pain management (7)

So, how does it work?

Well I’ll be totally honest, no one is 100% sure…

While research has found the outcomes on patient recovery to be very positive, the exact mechanisms are not fully understood.

We do however know that dry needling:

  • Stimulates vasodilation and increasing blood to flow to the area
  • Alters the transmission of pain inducing nerve signals at the spinal cord
  • Encourages the release of endorphins and other ‘happy’ brain chemicals

All of which can help reduce pain and help promote healing.

Now, the big question, does it hurt?

The honest answer? A little.

Most patients don’t feel the insertion of the needle itself, but the aim is to elicit what is known as a ‘local twitch response’, or muscle contraction which can vary in force.

This lasts for less than a second and can be described as anything from a little electrical shock to a cramp.  These twitches are however desirable as they encourage all the good bio mechanical reactions described earlier.

As with anything, dry needling is not for everyone, however it can be really useful in reducing pain and speeding up recovery time. For more information or to give it a go please feel free to give me a shout or pop by our HongKong street clinic for a coffee and a chat.

Annie Henderson

References:

1) Diener H C, Kronfeld K and Boewing G (2006) Efficacy of acupuncture for the prophylaxis of migraine: a multicentre randomized controlled clinical trial. Lancet Neurol. 5, 310-6
2) Furlan A D, van Tulder M W, Cherkin D, Tsukayama H, Lao L, Koes B W and Berman B M (2005) Acupuncture and dry-needling for low back pain. Cochrane Database of Systematic Reviews. Issue 1. Art. No.: CD001351
3) JOPPT (2013) Perspectives for Patients: Painful and Tender Muscles: Dry Needling Can Reduce Myofascial Pain Related to Trigger Points Muscles Journal of Orthopaedic & Sports Physical Therapy. 43(9), 635-635
4) Kietrys D M, Palombaro K M, Azzaretto E, Hubler R, Shaller B, Schlussel J M and Tucker M (2013) Effectiveness of Dry Needling for Upper-Quarter Myofascial Pain: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther. 43(9), 620-634
5) Linde K, Allais G and Brinkhaus B (2009a) Acupuncture for migraine prophylaxis. CochraneDatabaseSystRev. CD001218
6) Linde K, Allais G and Brinkhaus B (2009b) Acupuncture for tension-type headache. Cochrane database of systematic reviews. CD007587
7) Madsen N V, Gøtzsche P C, Hróbjartsson A (2009) Acupuncture treatment for pain: systematic review of randomized clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups. BMJ. 338, a3115.
8) Manheimer E, Cheng K and Linde K et al. (2010) Acupuncture for peripheral joint osteoarthritis. Cochrane database of systematic reviews (Online). CD001977
9) Melchart D, Linde K and Fischer P et al. (2001) Acupuncture for idiopathic headache. Cochrane Database Syst Rev. CD001218
10) Molsberger A F, Schneider T and Gotthardt H et al. (2010) German Randomized Acupuncture Trial for chronic shoulder pain (GRASP) - a pragmatic, controlled, patient- blinded, multi-centre trial in an outpatient care environment. Pain. 151, 146-54
11) Trinh K, Graham N, Gross A, Goldsmith C H, Wang E, Cameron I D and Kay T M (2006) Acupuncture for neck disorders. Cochrane Database of Syst Rev. (3), CD004870
12) Vas J, Ortega C and Olmo V et al. (2008) Single-point acupuncture and physiotherapy for the treatment of painful shoulder: a multicentre randomized controlled trial. Rheumatology. 47, 887-93
13) White A, Foster N and Cummings M et al. (2006) The effectiveness of acupuncture for osteoarthritis of the knee - a systematic review. Acupunct Med. 24 Suppl:S40-S48