- Dry Needling may mechanically disrupt a dysfunctional motor end plate
- Needling results in a Local Twitch Response (LTR)
- The LTR results in an alteration to muscle fiber length as well as having an inhibitory effect on antagonistic muscles
- Baldry (2001) suggests that dry needling techniques stimulate A-nerve fibers (group III) for as long as 72 hours post needling
- Prolonged stimulation of the sensory afferent A-fibers may activate the enkephalinergic inhibitory dorsal horn interneurons, which implies that dry needling causes opioid mediated pain suppression
- Another possible mechanism of dry needling is the activation of descending inhibitory systems which would block noxious stimulus into the dorsal horn
- The LTR may also utilize the excessive ACh in the tissue which previously was triggering increased firing of localized fibers
- Studies by Shah and colleagues (2001) demonstrated increased levels of various chemicals at sensitized motor end plates such as: Bradykinin, Substance P and CGRP (regulator of Calcium and Phosphate balance). These chemicals were reduced immediately post a LTR.
- CGRP enhances the release of ACh from nerve terminals, which results in increased ACh receptors at the neuromuscular junction
- Needle penetration will cause micro-trauma and micro bleeding (localized inflammation) and hence the introduction of PDGF into the area to help promote healing
Is Trigger Point Dry Needling Acupuncture?
No, Trigger Point Dry Needling is based on Western medical research and principles, whereas acupuncture is based on Traditional Chinese Medicine. The main similarity is that the same sterile, disposable solid filament needles are used. Although Dr. Mulhall is a Fellow for the International Association of Medical Acupuncture (FIAMA) and also practices acupuncture, he was trained through two separate organizations (The American Dry Needling Institute and KinetaCore) to provide detailed and specific TDN therapy and each therapy is a separate and distinct in their methodology, perspectives and practices.
What Types of Conditions Can TDN Assist?
- Neck/Back Pain
- Shoulder Pain
- Tennis/Golfers Elbow
- Hip and Gluteal Pain
- Knee Pain
- Achilles Tendonitis/Tendonosis
- Plantar Fasciitis
- Muscular Strains/Ligament Sprains
- Chronic Pain
- Athletic Performance
Does TDN hurt?
You may or may not feel the insertion of the needle. The specific needle manipulation is intended to produce a local twitch response that can elicit a very brief (less than a second) painful response some patients describe as a deep ache or cramping sensation. Again, the therapeutic response occurs with the elicitation of the local twitch response and is a desirable reaction.
What can I do to prepare for my therapy?
Eat a light meal 1-2 hours prior to your visit and wear loose, comfortable clothing that can be rolled up or down to access your areas of concern with the greatest ease.
What can I expect after treatment?
We are looking to get improvements even from the first visit such as increased range of motion, ease of movement and decreased signs/symptoms.
Many patients report being sore after the treatment in both the area treated and the area of referred symptoms. Typically this soreness lasts between a few hours and two days and there is occasional bruising. Soreness may be alleviated by applying ice or heat to the area and performing specific stretches for the treated muscle.