To trigger point with dry needling or not to trigger point for Musculoskeletal Conditions
Acupunture
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Acupunture -
Dry Needling has been used since the ’80s (Unverzagt et al., 2015). Since then it has been utilised by Osteopaths, physiotherapists, chiropractors even acupuncturists at times have chosen this form of needling to assist with their intervention to try to have a positive effect on myofascial trigger points.
Myofascial trigger point pain (MTrPs) is defined as “pain arising from one or more myofascial trigger points (MTrPs), which are hyperirritable spots in skeletal muscle that are associated with hypersensitive palpable nodules in taut bands (Unverzagt et al., 2015 ). These spots can be classified as ‘active’ MTrPs when they produce spontaneous pain and, when palpated, reproduce a patient's familiar pain. Although there are other MTrPs, which are referred to as ‘latent’ MTrPs although these do not produce spontaneous pain and are only painful upon palpation.
Dry needling these points is suggested to produce both local and central nervous responses to restore homeostasis at the site of the MTrPs, resulting in a reduction of both peripheral and central sensitization to pain. This can have an effect on pressure pain threshold, range of movement, decreasing muscle tone, and decreasing pain in musculoskeletal conditions (Gattie et al., 2017).
Dry needling has been shown as being shown to be more effective than a no-treatment control or sham dry needling for reducing pain. Furthermore, when dry needling performed by therapists is compared to other treatments, primarily soft tissue manual therapy techniques, there is moderate-quality evidence to suggest that it may be more effective at reducing pain (Gattie et al., 2017). Although manual therapy can not be ruled out this does still have its benefits and effectiveness. Campa - Moran et al., 2015 observed in their study that the manual therapy group had a great reduction in mechanical hyperalgesia and pain catastrophizing when compared to needling. Therefore, suggesting what works for some doesn’t necessarily work for others.
So to dry needle or to not needle, that is the question? If you are scared of needles then maybe not, but if you are up for it, personally I have seen great results from needles. Further supporting evidence In New Zealand an Osteopath must do;
(1) hold one of the qualifications prescribed for registration in the Scope of Practice – Osteopath and (2) hold one of the following qualifications: • Post Graduate Certificate in Western Acupuncture, Auckland University of Technology
• Post Graduate Certificate in Western Medical Acupuncture, University of Hertfordshire (United Kingdom). or (in addition to paragraph [ 1 ] above
This shows that any Osteopath in New Zealand who uses this form of treatment is highly skilled. Within the other professions such as chiropractors, physiotherapists, or acupuncturists their governing body will/should require them to hold some form of training.
If you are unsure, think about it or give it a go.
Reference list
Campa-Moran, I., Rey-Gudin, E., Fernández-Carnero, J., Paris-Alemany, A., Gil-Martinez, A., Lerma Lara, S., Prieto-Baquero, A., Alonso-Perez, J. L., & La Touche, R. (2015). Comparison of Dry Needling versus Orthopedic Manual Therapy in Patients with Myofascial Chronic Neck Pain: A Single-Blind, Randomized Pilot Study. Pain research and treatment, 2015, 327307. https://doi.org/10.1155/2015/327307
Gattie, E., Cleland, J. A., & Snodgrass, S. (2017). The Effectiveness of Trigger Point Dry Needling for Musculoskeletal Conditions by Physical Therapists: A Systematic Review and Meta-analysis. The Journal of orthopaedic and sports physical therapy, 47(3), 133–149. https://doi.org/10.2519/jospt.2017.7096
Unverzagt, C., Berglund, K., & Thomas, J. J. (2015). DRY NEEDLING FOR MYOFASCIAL TRIGGER POINT PAIN: A CLINICAL COMMENTARY. International journal of sports physical therapy, 10(3), 402–418. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4458928/#:~:text=Dry%20needling%20(also%20known%20as,the%20United%20States%20since%201984.