Treatment methods

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Dry Needling involves the insertion of acupuncture-type needles into muscles in order to relieve pain and restricted range of motion.   A myofascial trigger point is a tender “knot” in the muscle tissue. Most of us have these tender areas in various places in our bodies. You might feel a tight band of tissue for example in the upper trapezius muscle of your upper shoulder.  In the middle of that tight band, you might feel a small hard nodule. That’s a trigger point. The nodule will be painful when pressed and may also cause pain to radiate out to other areas.  A tight upper trapezius trigger point can cause headaches for example. Often, the trigger point that causes symptoms might be quite distant from the painful area. For instance, the gluteus minimus muscle in the hip can cause pain all the way down the leg.

Myofascial trigger points usually form when there is some kind of stress on the muscle. This may be from a sudden overload in a traumatic injury like a fall, a car accident or lifting something improperly. Or, it may happen over a long period of time for example from chronic postural stresses such as sitting at a computer. Most of us have movement patterns, which are not as efficient as they could be. We tend to overuse certain muscles, and underuse others. Also, trigger points can be caused by a problem with the nerves that supply the muscle. This often happens near the spine where the nerves exit from the spinal column. There may be a degenerated or herniated disc, or some arthritis in the joints of the spine. If the spinal nerves become compressed or irritated, the muscles that the nerves supply, become more irritable and are likely to develop trigger points. 

This leads to a “vicious cycle” of pain and dysfunction.  If you have pain in your shoulder, elbow or hand there may also be a problem in your neck. If you have hip, knee or foot pain you will usually benefit from treatment to your low back.

The fancy technical details....

There is ongoing research about what’s actually happening physiologically at a trigger point. We know that there is a continued release of certain neurotransmitters at the junction where the nerve and muscle meet. This causes a self-sustaining contraction in part of the muscle It holds on, and doesn’t usually let go until it is treated. Also, there is a low level of spontaneous electrical activity at the trigger point site. Because of the muscle tension, there may be some pressure and irritation on the nerve fibers and blood vessels in the area. This causes pain and tenderness in the area, and the decreased circulation causes an “energy crisis” at the trigger point.

Trigger point dry needling is an advanced therapeutic technique that involves placing a small needle into a muscle in order to cause a quick contraction that releases the trigger point. This release improves flexibility and circulation in the muscle and can lead to a decrease in pain and other symptoms. Dry Needling can significantly improve range of motion in post surgical knees and shoulders, and is an effective treatment of low back pain and chronic conditions.

Dry Needling is not acupuncture. Acupuncture is based on restoring flow of energy (“chi”) along meridians in the body. Dry Needling is based on modern Western scientific principles and our knowledge of anatomy and physiology. We needle muscles that harbor trigger points.

We are not here to fix you independently of your help.  You will be required to be an active participant. We are here to educate you on why you are in pain and how to fix it. We will guide you with treatments, education and exercise into making the necessary changes to achieve long lasting results that you are able to reproduce at home. We have seen a direct correlation between length of treatment and those who are doing work at home and those who aren't.

During you initial evaluation, an extensive history will be taken to rule out red flags and other issues that may affect successful outcomes. You will then be put through a movement screen to look at global movement. From there we will further break down the movement deficits that are related to your pain and dysfunction. As we do this, we are looking at movement habits that you may or may not be aware of which are affecting you pain and function.

As this is done, we test movements to see which improves your symptoms and which increases discomfort. The movements/exercises showing improvement are the same exercises you will receive for home completion. You will NOT be burdened with a large exercise program, typically you are asked to do 2-4 exercises.  The exercises you are asked to do are custom to YOUR needs.  We do not give cookie-cutter exercises to every patient with the same area of pain.  

You are taught how to complete these exercises correctly and efficiently.  To help keep your movements consistent when you work at home, we will either take video of you performing them here in the office on your personal cell or email links to videos through a patient portal.  Therapy in the office will not be at its most successful, leading to a waste of your time and money, if follow-up work is not done at home.   Doing your 'homework' is how you will continue to progress each week with new exercises.

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