Dry Needling for Shoulder Pain
Dry Needling for Shoulder Pain
What is Dry Needling?
Dry Needling is a needle therapy used to relieve trigger points . Dry needling was pioneered by Janet Travell, M.D., author of “Myofascial Pain and Dysfunction: Trigger Point Manual” in the early 1960’s. This was before Chinese acupuncture had made its way to the USA.
What Are Trigger Points
A Trigger Point (TrP) is a “palpable nodule in the taut bands of the skeletal muscles’ fascia.” We all have latent trigger points that dont bother us. But when we overuse a muscle, or a muscle experiences trauma, that our latent trigger points can become “activated.” Active TrP’s can be exquisitely tender, and can refer pain to other parts of the body.
Trigger Points and Pain
Trigger points feel like knots in the muscles. These muscle will feel tense. They are very common in cases of shoulder pain and rotator cuff pain. This is why dry needling for shoulder pain is so effective.
A common active TrP is between the shoulder blades in the rhomboid muscles. Another one is in the upper trapezius where most of us like to receive a shoulder “rub”. These trigger points can be at the root of tension headache and even migraine headach. TrPs in the jaw and scalp also often contribute to headache pain.
Frozen shoulder/adhesive capsilitis, tennis elbow, golfer’s elbow, are some of the pain conditions I have treated succesfully here in San Diego with dry needling.
Janet Travell’s Method: Dry Needling to Release Trigger Points
In Dr. Travell’s method, trigger points are punctured by either a low gauge solid filliform needle (another words an acupuncture needle) or by a hypodermic needle. In fact, Dr. Travell practiced both dry needling, and the injection of lidocaine into trigger points. But over time she found that it is the action of the needle itself that has the efficacy, not the lidocaine.
In fact a study in the UK found that dry needling, injection of lidocaine, and injection of saline placebo were all equally effective. The researchers found its the mechanical affect of the dry needle that eliminates the trigger points at the source of the pain.
Sir William Osler’s Method
In fact, Sir William Osler, M.D., one of the father’s of American medicine, practiced myofascial dry needling using bonnet pins! Writing, in the late 1800’s, to a friend, Osler had this to say:
“For lumbago acupuncture is, in acute cases, the most efficient treatment. Needles from three to four inches in length (ordinary bonnetneedles, sterilized, will do) are thrust into the lumbar muscles at the seat of pain, and withdrawn after five or ten minutes. In many instances the relief is immediate, and I can corroborate fully the statements of Ringer, who taught me this practice, as to its extraordinary and prompt efficacy in many instances.”
In fact, Osler included a section on the use of acupuncture for the treatment of “lumbago and sciatica” in his respected textbook The Principles and Practice of Medicine. This was the standard medical school text from 1892 all the way until 1949.
Chinese Style Myofascial Acupuncture versus Channel Based Acupuncture
Chinese style Myofascial Acupuncture is based on the “sinew channels.” What Chinese Medicine calls the “sinew channels” are actually an early mapping of the fascial flows in the body. The sinew channels include Trigger Points, called “ah shi” points…
When we needle the sinew channels of classical acupuncture we deactivate trigger points in the muscles. Chinese acupuncturist who do this method use thicker needles to puncture contraction knots with a high degree of precision. This method is also used by acupuncturists in China and Taiwan who work in the field of the Martial Arts.
On the other hand, lighter styles of acupuncture, such as Japanese style, or some of the American styles, require very shallow insertions of thinner gauge needles, as well as a detailed knowledge, not of western anatomy, but of the channel networks and connections.
These systems of acupuncture, which emphasize light needling of distal points on the body, away from the actual site of pain, are generally ineffective for myofascial trigger point pain, but can be very effective for digestive problems, insomnia, and a million other somatic issues.
Is Dry Needling A Kind of Acupuncture?
As you can see, some forms of acupuncture are not at all the same as dry needling. On the other hand the term dry needling can refer quite specifically to what some people call Sports Acupuncture or Myofascial Acupuncture. This is dry needling of trigger points.
People who do sports acupuncture may also needle motor points to further release tight muscle. I like to do both.
Whether you call it dry needling or myofascial acupuncture, deactivating trigger points is successful in the treatment of a wide range of sport’s injuries, overuse injuries, sprains, strains, and even sciatic pain. This is because when you release the the trigger points and motor points, muscles lengthen, and the pressure on tissues and nerve roots is lessened.
In my San Diego dry needling practice I specialize in the use of dry needling for shoulder pain, and also neck, hip, and back pain.
I use dry needling in the treatment of various kinds of shoulder pain, ranging from frozen shoulder, or adhesive capsilitis, to throwing injuries, rotator cuff injuries, and generalized tightness.
Some of my most common shoulder pain patients are para legals and stylists. Paralegals and stylists frequently overuse their shoulders. Stress is also a factor.
Bodymind Wellness Center San Diego Dry Needling of Shoulder Pain with Dry Needling, Cupping, Acupuncture and Chinese Herbal Medicine
Causes and types of shoulder pain.
- Adhesive Capsulitis/Frozen Shoulder
- Chronic pain associated with tension in the muscles and fascia of the upper trapezius, cervicals, and rotator cuff muscles
- Shoulder pain associated with tension and migraine headaches
- Acute sports injuries like bicipital and supraspinatus tendonitis, rotator cuff injuries, torn labrum
1) Dry Needling to increase the range of motion of the muscles that act on the shoulder joint:
Upper Trapezius, Subscapularis, Pectoralis Major and Minor, Supraspinatus, Infrspinatus, Teres Major and Minor, Deltoid, Rhomboids, and Latisimus Dorsi.
I also release the trigger points of paraspinal muscles around the spine near the shoulder
2) I use the trigger point dry needling to release fascial adhesions that restrict range of motion
3) I oftens use E-stim (Electrical Stimulation) to help break up fascial adhesions . I especially like electrical stimulation for Frozen Shoulder.
Cupping also helps to increase blood circulation. This helps reduce inflammation.
5) I use Heat treatment with a TDP Long Range Infrared Lamp. Infrared heat reduces the inflammation that causes pain..
6) I apply counter-irritant Chinese Herbal Linaments. This helps relieve post treatment soreness by improving blood circulation and reducing inflammation.
7) I often prescribe anti-inflammatory and analgesic Chinese herbal medicines taken by mouth, of the type used in the martial arts for millenia.
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