Dry Needling: The Precise Trigger Point Therapy

Dry Needling is a very effective form of Trigger Point Therapy. Dry Needling is relevant for both myofascial trigger points and the fascia, where specially trained practitioner needles a trigger point using sterile acupuncture needles. The pin prick action stimulates oxygenation of the contracted muscle fibers and the fascia, reduces inflammation, improves blood circulation and thus reduces the local tension in the tissue with long lasting results, sustainably. The pin prick into the trigger point produces a short contraction of the taut band, known as the local twitch response. The local twitch response is often described by patients as a pleasant "good pain" with a sense of release.

History of Dry Needling

The needles used in Dry Needling are sterile disposable needles, sized usually 0.16mm – 0.3mm thick and 1.5 cm – 6 cm long. The choice of needle depends on the depth of the trigger point within the tissue, and on the dry needling technique that is used.

The needles used in Dry Needling are sterile disposable needles, sized usually 0.16mm – 0.3mm thick and 1.5 cm – 6 cm long. The choice of needle depends on the depth of the trigger point within the tissue, and on the dry needling technique that is used.

Dry Needling of the trapezius muscle. During Dry Needling, trigger points which are located manualy first, are treated precisely.

Dry Needling of the trapezius muscle. During Dry Needling, trigger points which are located manualy first, are treated precisely.

Dry Needling Is Not Acupunture!

Although thin disposable acupuncture needles are used in Dry Needling, the two techniques are quite different. Dry Needling aims at treating specific trigger points diagnosed beforehand in muscle tissue, and the goal is to release myofascial trigger points or adhesive soft tissue and fascia. That lies in contrast to an Acupuncture treatment in which generally Acupuncture points lying in different tissue types are punctured in order to achieve different goals.

Dry Needling originated from clinical observations and studies treating trigger point using injections. Over time, evidence has shown that it was not the substance injected that was responsible for the relase of the trigger point, but the accurate needling to the area. The work of Karel Lewit (1916-2014), a Czech doctor who published in 1979 the article "The Needle Effect in the relief of Myofascial Pain" in the renowned journal "Pain", as well as the work of Dr. P. Baldry and Dr. C. Gunn in the eighties, served as benchmark for the development of the Dry Needling concept. In the early nineties Christian Gröbli and Ricky Weismmann combined Dry Needling with Travell and Simons's findings of trigger point therapy and developed a systematic Trigger Point Dry Needling concept. Since then that method is continuaslly being developed and taught by the DGSA. Today, Dry Needling is an accepted successful technique used by practitioners worldwide in pain management.

Different Forms of Dry Needling

Dry Needling refers to both drug-free needling of trigger points in the treatment of myofascial pain and dysfunction, as well as the treatment of other musculoskeletal pain using sterile disposable acupuncture needles. There are basically two different types of Dry Needling:

  • intramuscular stimulation (IMS) and
  • superficial Dry Needling (SDN).

In IMS the needle is inserted directly into the trigger point or taut band. This triggers a local twitch response (LTR) of the taut band. The LTR is perceived by many patients as a sensation of muscular release, being a sign that the right trigger point was needled. In addition, there is evidence to support the therapeutic value of the LTR in enhancing the release of fascia related adhesions, as well as reduce inflammation around the Trigger Point.

In SDN, the needle is inserted superficially obliquely to the skin surface, to about 3-4 mm above the trigger point or painful area, which triggers several reflex analgesic mechanisms via the spinal cord and the brain.

Another method of Dry Needling is the intramuscular electrical stimulation (IMES), where at least two needles are inserted into the taut band and are stimulated by light TENS currents.

The right technique must always be chosen and adapted according to the patient and his complaints.

Dry Needling of the gluteus medius muscle

Dry Needling of the gluteus medius muscle

Dry Needling of the gastrocnemius muscle. There are two forms of Dry Needling: intramuscular Dry Needling or superficial Dry Needling.

Dry Needling of the gastrocnemius muscle. There are two forms of Dry Needling: intramuscular Dry Needling or superficial Dry Needling.

Safety and Hygiene During Dry Needling

Dry Needling is a safe treatment technique which requires comprehensive and professinal training with sound knowledge of anatomy and palpation skills. The practitioner must always be aware of the exact tissue or structure where the needle is inserted. Complications can be safely avoided providing the practitioner follows the recommended safety guidelines and contraindications as well as the principle “in doubt stay out”. Our ultimate goal in our Dry Needling courses is safe and complication-free Dry Needling.
Dry Needling must be applied under hygienic conditions using only disposable sterile needles and a disinfectant to disinfect the needled area.
Before needling the practitioner has to examine potential contraindications in each patient, as well as identify relevant anatomical landmarks and be aware of the potential local precautions.

Dry Needling is applied under hygienic conditions and when applied correcly, it is considered a safe and highly effective treatment technique for acute and chronic musculoskeletal pain.

Dry Needling is applied under hygienic conditions and when applied correcly, it is considered a safe and highly effective treatment technique for acute and chronic musculoskeletal pain.