Dry Needling and Trigger Points
What are trigger points? Why are they so painful? Why do we feel the need to get rid of them?
A trigger point (a.k.a knots) located within the muscle tissue is a dense collection of sensitised muscle nerve fibres. They are usually found in tight muscles or the fascia surrounding it. There are two types of trigger points, active trigger points and latent trigger points.
An active trigger point is when the muscle nerve fibres gives out persistent, low grade dull aches. No wonder you are so dead set on getting rid of it! The sensitisation of these nerves is due to inflammation. Pain is the body’s way of asking us to pay attention to the area. Referred pain can also be caused by active trigger points. For example patients with low back pain, trigger points are most commonly found within the gluteal muscles (figure 1) or even quadratus lumborum (figure 2). Headaches can be referred from trigger points within the upper trapezius or levator scapulae (figure 3).
On the other hand, latent trigger points are only tender when pressure is applied. However both types of trigger points may cause movement restriction and weakness.
So, how does dry needling help?
Dry needling aims to stimulate muscle nerve fibres that are located near the surface of the muscle. By doing so, the body modulates the effect of sensitised muscle nerve fibres and inhibits onward pain transmission. By reducing the amount of signals the nerve is transmitting, the muscle can start to relax. This then allows the physiotherapist to continue working on the affected muscle without causing too much pain.
For the best outcomes, dry needling should be accompanied by other treatment techniques like soft tissue release, strength training and even providing the muscles with warmth. Dry needling is just one of the many techniques your physiotherapist can provide to help with healing.
Dry needling is also commonly known to cause post treatment soreness, this is common for most. The discomfort should subside within 24-48 hours and the benefits of dry needling should start kicking in. Resting after a dry needling session with a heat pack over that specific muscles would usually help to ease the discomfort.
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