Dry Needling is a manual therapy technique used by Myotherapists to help reduce pain and tension in muscles.
We've previously discussed the similarities and differences between Dry Needling and Acupuncture, but you may still be wondering - how does Dry Needling actually work?
The "Dry" Needle
The reason they are called "dry" needles is to differentiate them from hollow needles like the ones used for blood tests or vaccinations. A dry needle can't inject or withdraw fluids from your body.
The needles themselves are ultra thin and flexible. They come with a guide tube to allow us to place them with care and precision.
All needles used for dry needling are single use only.
Where We Apply It
Myotherapists use dry needling in painful, tight or restricted muscle groups. You may have heard about Trigger Points - those painful, tight bands that can form within a muscle over time, with repeated use or from injury. Dry needling is a technique that helps address these trigger point areas in a very specific and precise way.
We assess the areas through watching you move and through palpating the muscles to find the best spots within the muscle to position the needle to relieve the trigger point. We also assess the surrounding joints and muscles, for example for hip pain we may find that dry needling in your lower back or in your thigh can help relieve pain and strain from your hip.
What Happens When We Needle A Trigger Point?
When we first insert the needle to the muscle, it can be felt as a little pinprick sensation on the skin. We then guide the tip of the needle into the right angle and depth of the muscle to directly stimulate the trigger point. This takes some skill and the ability to visualise in 3D the target muscle and the surrounding tissue like nerves, veins, arteries, bones and ligaments.
By applying the needle into that trigger point, it causes a combination of chemical and electrical responses by the muscle. The micro damage causes by inserting the needle sends chemical messengers to the brain to get a healing response to occur. It can also cause a nerve impulse to occur, making the muscle twitch and release.
To Stimulate or Not To Stimulate
Because our aim in using dry needling is to get a change in the muscle tension, we often can stimulate the needle. This means we might gently move the needle in a pulsing in/out movement to repeatedly stimulate the trigger point, or we might twist the needle in a particular direction or in a series of back and forward movements.
Stimulation of the needle can lead to more twitching, what we call Local Twitch Response. Dry needling can be effective even without the involuntary muscle twitch response.
Some practitioners prefer a more intensive stimulation of the needles, however we prefer a gentle and slow approach.
Does Dry Needling Hurt?
In most cases, not really. Which is often surprising! The most common sensations you'll feel are the pinprick of the needle being positioned, a dull aching or tightening sensation around the needle, and the quick twitching response of the muscles releasing. The twitching can sometimes feel intense, but only lasts a very short time.
After needling, some people can experience a little localised soreness at the sites of the needles, but most people just feel relief from tension and pain in those areas.
Is Dry Needling Safe?
In the hands of a trained practitioner, dry needling is a safe and effective technique.
Myotherapists undergo many months of training and assessment in the skillful use of dry needling, however not all practitioners who offer dry needling are Myotherapists. Remedial Massage Therapists, Chiropractors, Physiotherapists, and other skilled practitioners can opt to undertake short courses in dry needling.
Here in the Simple Wellness Myotherapy clinic, we only allow our Myotherapists to use dry needling on our patients, and we strongly believe that a weekend short course is not enough time to develop the skills needed to use dry needling safely and effectively.
What Sort Of Pain Can Dry Needling Help Treat?
Dry needling is great for releasing tight trigger point areas all throughout the body. It can be effective in treating headaches, neck and shoulder pain, back pain, bursitis, pain from disc injuries, sports injuries, plantar fasciitis - so many things!
Want to try dry needling for your muscle pain? Book an appointment with one of our Myotherapists.
Many people are familiar with the term "bulging disc" in regards to lower back pain. It can feel like an intense, sharp, stabbing sensation that can often travel down your leg through your hips and bum, sometimes as far as your feet.
This is a common diagnosis when you start to develop back pain. You get a scan which shows changes in the disc, and the pain matches the effected nerve area. It can be a scary diagnosis.
But you may be surprised to know that a lot of people who don't have pain have also been found to have changes in their discs. I find this study to be really encouraging, because it shows that people who have significant changes to their disc structure can still live a painfree life. It suggests that the disc changes may have already been there for some time before any painful symptoms even began, and gives hope that even if the structure doesn't change, that the pain can change.
Lets have a look at this interesting literature review, particularly in regards to the findings around disc degeneration, disc bulges and disc protrusions.
This is a literature review of 33 separate studies that investigated the imaging of spinal degeneration in painfree people ranging from their 20's to their 80's. It was published in the American Journal of Neuroradiology in 2014.
In total, the review takes into account MRI and CT scan imaging on 3110 individuals with no painful symptoms.
As you would likely predict, the number of findings increased with the participants age group, showing age-related degeneration occurs even in people who aren't experiencing pain.
Lets have a look at the imaging results for the disc degeneration, bulge and protrusion categories:
Disc degeneration - changes to the disc and surrounding vertebrae that result in loss of cushioning and support, may include signs of osteoarthritis at the joint.
Disc degeneration in painfree participants was identified in:
Disc bulge - changes that alter the shape of the disc and can make portions of it "bulge" out of place, which can apply pressure to nearby nerves.
Disc bulge in painfree participants was identified in:
Disc protrusion - changes to the annular membranes around the disc allows the disc nucleus to protrude and apply pressure to the nerves.
Disc protrusion in painfree participants was identified in:
What does this mean for your bulging disc?
It means that theres a good chance that your structural changes were already present before your back became painful. The area may be irritated or flared up right now, but these findings are a good indication that even if your scans don't change, your back pain still can settle down.
It means that a scan showing disc changes doesn't have to be a life sentence of pain.
Does this mean bulging discs DON'T cause pain, then?
Don't get me wrong, bulging discs can be painful, and for some people it can be severe. This study just helps to show us that theres more to back pain that what shows up on MRI or CT scans. Structural changes are just one layer in the complex onion that is back pain.
We can help!
There are lots of ways we can change your experience of back pain through massage and myotherapy techniques like dry needling, taping and support, strengthening the surrounding muscles with exercises that are appropriate for you, and supporting your understanding of how your back functions.
Book a time to come see us to talk about your back pain and creating a treatment plan to reduce it.
If you have joint pain, chances are that hydrotherapy is going to be a huge help to you.
A hydrotherapy pool is a warm water pool for doing exercises. Its quite different from swimming laps, although a lot of people find that swimming can be helpful too, if its not painful to do it. Can’t swim? It doesn’t matter, a hydrotherapy pool is usually quite shallow, it usually doesn’t have a “deep end” where you can’t touch the bottom.
Our local hydrotherapy pool is at Knox Leisureworks in Boronia. The centre has a lot to offer, actually. There is the hydrotherapy pool, as well as a kids pool, a regular lap pool, a spa and sauna, and an onsite gym.
So why is Hydrotherapy such a great option?
Buoyancy – Being in the water takes the pressure off the joint due to the water supporting your body weight. This makes it a great option for weight bearing joints like hips, knees and ankles, especially following injuries or surgeries like hip and knee replacements or fractured bones.
Warmth – Heated hydrotherapy pools allow muscles to stay warm and relaxed while exercising. Typically a hydrotherapy pool is heated to about 33*, warmer than a normal swimming pool.
Low Impact – Unlike running, doing exercises in water is friendly on vulnerable joints. The water doesn’t allow you to move as fast as in air, so the force of impact is less than running or jogging on a hard surface.
Resistance – The water provides great resistance for strengthening the body, without feeling painful. It can be tiring afterwards due to the resistance of the water, though, so starting with short sessions is best.
Low Cost – Knox Leisureworks has a great hydrotherapy pool. You can access the hydro pool with your standard pool entry fee of around $8, or if you plan to go frequently they have multi visit passes or memberships.
What kinds of pains or conditions does it work well for?
Hydrotherapy is fantastic for helping with pain in big joints and weight bearing joints, like hips, knees and ankles. Lower back pain can respond very well to hydrotherapy because of the way the water helps take pressure off the spine and support the weight of the body while you move. It can also be great for things like arthritis, and rehabilitation after a fracture or surgical repair.
It can be great for general fitness, too!
How do you get started?
Initially just walking through the water can be really helpful. You can also include day to day movements like bending and straightening your knee or hip while standing with you back against the pool wall for support. You can use a floating board or pool noodle to hold onto and do gentle squats or lunges.
If you’re uncertain, talk to us about specific pool exercises at your next appointment and we can help create a program tailored for you.
Mel is a Myotherapist based in Ferntree Gully.