Dry Needling treatment of trigger points (TrP)

Dry Needling Treatment for Trigger Points (TrP)

Dry Needling is an effective minimally invasive addition to manual trigger point therapy for releasing myofascial trigger points (MTrP). In this process, the MTrP is precisely targeted with an acupuncture needle (without medication) to relieve muscle tension.

The Dry Needling procedure follows three steps. As in manual trigger point therapy, the taut band along with the associated MTrP is located using precise palpation, and the area with notable pressure sensitivity is isolated.

The needle is inserted into this area, and the MTrP is identified through fan or cone techniques. The physiotherapist monitors the needle's intrinsic movement, the so-called Twitch Response. During manual examination and treatment, this Twitch Response is often difficult to trigger - however, it is very noticeable and easily inducible with Dry Needling. Recent studies indicate that Dry Needling is most effective when this local Twitch Response occurs.

The underlying hypothesis is that the insertion rapidly depolarizes the affected muscle fiber, which results in twitch manifestations. As the Twitch Response subsides, the spontaneous electrical activity of the muscle fiber decreases, and pain and dysfunction dramatically reduce.

The treatment itself has various approaches. The dynamic technique stimulates the trigger point area with short amplitudes in half-second intervals. The static technique involves inserting the needle into the trigger point as accurately as possible. The needle remains in the MTrP and can be further released by 'twisting' or 'pushing.'

In both techniques, the physiotherapist observes the reactions of the needle and the patient. The Twitch Response is evident in the twitching of the taut band and the acupuncture needle. Around the needle arises an intense local pain or an unpleasant cramping sensation. Additionally, the patient's recognized referred pain should occur.

The needle is left in the MTrP for 20-30 seconds to several minutes or until the pain or cramping subsides. Or until the patient says 'Stop.'

The goal of Dry Needling is the same as manual trigger point therapy. The contracted spot in the taut band should release and the post-intervention inflammatory response should be activated. The muscle relaxes.