Discover the opinion of a physiotherapist on dry needling, also called dry puncture. It is a technique that has been used for about ten years in physiotherapy worldwide. In France, this practice has only been authorised since 2017.
What is dry needling ?
It is an invasive technique practised by physiotherapists or doctors specially trained to treat pain or muscle knots and contractures often associated with certain pathologies. These include neck pain, lower back pain, muscle pain, tendonitis, neurological conditions etc. Unlike manual therapy, dry needling allows us to access deep areas in a more precise way, which makes this technique very effective in certain pathologies.
Practitioners use sterile dry needles to treat painful myofascial trigger points, otherwise known as “muscle contraction nodes”. The practitioner locates the trigger points in the muscle cord that cause the patient’s pain. Then, he introduces the needle intramuscularly at the level of the trigger points, the objective being to generate a micro-crack in the muscle structure.
What happens in the muscle ?
- Better oxygenation in the muscle cord
- Reduction of the inflammatory response
- Promotes tissue vascularisation
- Release of tension
Another method can be used, the SSA or superficial simulation of the afferences. This technique can be used to reduce chronic pain such as fibromyalgia.
How is a trigger point formed ?
Firstly, the trigger point is what is more commonly known as a “knot”. It is this point that is painful during movement and sometimes even at rest. These are contractures in the muscle fibres, the causes can be :
- Repeated movements
- A prolonged muscle shortening position
- Stress and anxiety
- Trauma
- Ect...
When to use dry needling ?
Dry puncture is interesting for treating certain pathologies
With dry needling we can treat muscular contractures often linked to lumbar pain, neck pain, muscle injuries and tendinopathy. It is a tool that helps the patient to better tolerate therapeutic exercises, to reduce inflammatory reactions, to relax the muscles, to accelerate muscle recovery, to reduce muscle fatigue, etc…
- Low back pain
- Neck pain
- Tendinopathies
Dry needling has been proven to be effective in patients with lateral epicondylitis. Indeed, the latest studies have shown that dry needling is more effective than corticoids. Dry needling significantly reduces pain but does not improve muscle strength and function. Therefore, therapeutic exercises are unavoidable in this treatment. Eccentric-concentric training combined with isometric contractions are essential for the treatment of epicondylitis. To date, no studies have compared dry needling VS therapeutic exercises.
An interesting technique for athletes
One study was able to show the detrimental effect of symptomatic and asymptomatic trigger points present in muscle cords. These muscle knots can be responsible for an acceleration of muscular fatigability and an alteration of the control of muscular activity. According to this study, the use of dry needling would allow the release of trigger points to improve sensorimotor function and obtain better motor control. The advantage is that it can be used before or after a competition without reducing sports performance. Nevertheless, it should be noted that dry needling can cause local pain that is more or less tolerated. It is therefore important to use this technique in athletes for the first time well before a competition.
The opinion of a physiotherapist trained in Dry needling
As a physiotherapist practising dry needling my opinion is positive. Indeed, this method has been beneficial for patients with trigger points in the calves, glutes, rotator cuff and epicondylial muscles associated with tendinopathies (epicondylitis, alquilateral tendinopathy, shoulder-related tendinopathies). I have seen a better tolerance of therapeutic exercises by patients who have received the dry acupuncture technique before. Indeed, it can be interesting at the beginning of the treatment when the pain is intense. Obviously, the improvement in oxygenation and vascularisation reduces pain during the session. During the rehabilitation sessions, patients adhere more easily to the dry needling technique.