As a physiotherapist in Edmonton, I have been using functional dry needling in my
practice regularly and have seen firsthand the clinical benefits it can provide to patients experiencing a wide range of musculoskeletal conditions. Functional dry needling is a relatively new technique that has gained popularity among physiotherapists and other manual therapists in recent years. It involves the use of a fine, solid filament needle to stimulate trigger points or myofascial release points in the muscle tissue, with the goal of relieving pain and improving function.
Although the technique has been used in traditional Chinese medicine for thousands of years, the modern use of dry needling as a therapeutic intervention can be traced back to the work of Dr Janet Travell in the 1940’s and 1950’s. Dr Travell was a physician and researcher who specialised in the treatment of myofascial pain syndromes, which are characterised by the presence of trigger points in the muscle tissues. She developed a technique called trigger point injection, which involved the injection of a local anaesthetic in trigger points to relieve pain and improve function. In the 1970’s and 1980’s, a number of researchers and clinicians began to explore the use of dry needling as an alternative to trigger point injections. They found that the use of a fine solid filament needle to stimulate trigger points could provide similar benefits to injection, without the associated risks.
What is a Muscle Trigger Point?
Muscle trigger points are localised areas of tenderness and sensitivity with taut bands of skeletal muscle fibres. They are commonly associated with the development of myofascial pain, which is a common condition affecting the musculoskeletal system.
Recent research has shed light on the mechanism underlying the development and maintenance of muscle trigger points. One widely accepted theory is that trigger points are caused by the excessive release of acetylcholine at the neuromuscular junction, which leads to sustained muscle contraction and the formation of taut bands in the muscle fibres.
Other studies have shown that trigger points can also result from a variety of additional factors, including mechanical overlord, muscle fatigue and muscle ischemia (reduced blood flow to the muscle). These factors can lead to the accumulation of metabolic waste products and the formation of local areas of low oxygen and nutrient supply, which can contribute to the development of trigger points.
So how can functional dry needling help?
1. Stimulation of local blood flow:
The insertion of needles into the skin and muscle tissue can stimulate the release of
chemicals that promote the dilation of blood vessels. This can increase local blood flow to the targeted muscle, which can provide oxygen and nutrients to the tissues and promote healing. One recent study “Effect of dry needling on local blood flow and microvascular response in a rabbit model of peripheral ischemia” by Wu et al. showed that FDN increased blood flow and improved microvascular response in the ischemic hind limbs of rabbit. Increased blood flow to an area can help promote healing and repair, which can ultimately improve tissue health.
2. Release of endogenous opioids:
FDN can stimulate the release of endogenous opioids, which are natural pain-relieving
chemicals produced by the body. These chemicals can bind to receptors in the nervous system and reduce the sensation of pain. While there is some evidence suggesting that dry needling can lead to the release of endogenous opioids it is important to note that this is still an area of ongoing research and debate. There are a few peer-reviewed studies that investigate the potential relationship between functional dry needling and the release of endogenous opioids such as the recent study "Dry needling improves muscle function following injury by increasing the number of myofibers with centralized nuclei" by Li X et al.
3. Activation of neural pathways:
The insertion of needles can activate specific neural pathways in the body, including sensory and motor pathways. This can improve communication between the brain
and the targeted muscle, which can enhance muscle function and reduce the risk of further injury. While the results of these studies are not all consistent they do suggest that functional dry needling can have an impact on neural pathways and may be useful treatment option for certain musculoskeletal conditions.
4. Relaxation of muscle tension:
Functional Dry Needling can help to reduce pain by targeting specific muscles that may
be tight or injured. It can help to reduce muscle tension by releasing trigger points or areas of muscle tension. This can help to improve mobility and reduce the risk of muscle strains or tears. A number of studies used different techniques to assess the effects of functional dry needling on muscle tension, including measurement of muscle blood flow and oxygenation, surface electromyography and subjective pain ratings. The results suggests that functional dry needling can cause relaxation of muscle tension and may be an effective treatment option for certain musculoskeletal conditions. By releasing tension in these muscles, the body is able to relax and reduce the sensation of pain.
Overall, FDN is a safe and effective treatment approach that can provide a range of neurophysiological benefits for individuals with muscle pain or injury. At Shift Physiotherapy & Wellness we have qualified and highly experienced physiotherapists ready to determine if dry needling is an appropriate treatment option for your specific needs.
If you have any further questions about Functional Dry Needling please contact Shift Physiotherapy & Wellness or book with one of our certified physiotherapists in Edmonton.
References
A Randomized Controlled Trial of Dry Needling Versus Stretching for Subacute Trapezius Myofascial Pain Syndrome. Fernández-Carnero J, La Touche R, Ortega-Santiago R, et al.
The immediate effect of dry needling on cervical range of motion and electromyographic activity of the upper fiber trapezius muscle in subjects with cervical myofascial pain syndrome. Chen X et all.
Bennett, Robert. (2007). Myofascial pain syndromes and their evaluation. Best practice & research. Clinical rheumatology. 21. 427-45. 10.1016/j.berh.2007.02.014.