Physicians Dr Travell and Simons defined a myofascial trigger point as a “Hyperirritable spot in a skeletal muscle.” The spot is painful on compression and can give rise to characteristic referred pain, referred tenderness, motor dysfunction and autonomic phenomena.
Myofascial trigger points (MTrPs) are commonly seen in both acute and chronic pain conditions. Hendler and Kozikowski cite Myofascial trigger points as the most commonly missed diagnosis in chronic pain patients.
Over the years it has been shown that it is possible to deactivate TrPs by injecting them with a large number of disparate substances (Lu & Needham 1980) The only reasonable inference drawn from this is that the pain relief obtained is not dependent on the specific properties that the substance may contain but rather on the stimulation of the needle used for the injection itself.
One of the first physicians to employ Dry Needling extensively for this purpose was Dr Karel Lewit of Czechoslovakia . Lewit (1979) reported favourably on the use of this technique in a series of 241 patients with musculoskeletal pain. The work of Hong and Jennifer Chu support Lewitt’s work and emphasize the therapeutic importance of eliciting a LTR (local twitch response).
Dry Needling may mechanically disrupt the integrity of the dysfunctional endplates within the trigger area – resulting in mechanical and physiological resolution of the MTrPs. A fascinating new study by Jay Shah shows biochemical changes in the MTrPs following twitch elicitation. This was done by real time blood micro- sampling of the MTrPs as it was needled.
Many years of work by Drs David Bowsher and Peter Baldry amongst other show a strong pain inhibitory role played by Opioids released by needling stimulation of A delta receptors.
Dr Chan Gunn in his I.M.S. approach and Dr Fischer in his segmental approach to Dry Needling strongly advocate the importance of clearing MTrPs area in both peripheral and spinal areas.
Today many Medical doctors, Physiotherapists, Chiropractors and Acupuncturists are using Dry Needling effectively and extensively within their practices for the treatment of Myofascial Pain & Dysfunction.
Dry Needling is a recommended techniques for treating MTrPs (Dommerholt & Huijbregts 2010; Tough et al 2008).Dry Needling is the name given to the use of medical grade needles in the treatment of myofascial pain and dysfunction. It is a therapeutically and theoretically distinct entity, not to be confused with the Traditional Chinese Medicine (TCM) technique of acupuncture (Travell and Simons 1999). It has been operationally defined by the Virginia Board of Physical Therapy’s Task force on Dry Needling thus:“Dry Needling is a technique used to treat myofascial pain that uses a dry needle, without medication, that is inserted into a trigger point with the goal of releasing/inactivating the trigger points and relieving pain” (Virginia Board of Physical Therapy 2007: 2).
Optimal Dry Needling Solutions provides comprehensive training in this technique both within Southern Africa and Internationally.
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