How Dry Needling Relieves Pain and Treats Injuries

Dry Needling is the single most effective method for releasing painful trigger points in muscles and fascia. A high percentage of acute and chronic pain is caused by trigger points.

What Are Trigger Points?

Trigger points are focused areas of hyper-irritability in muscles and their related fascia. We all have latent trigger points in predictable locations throughout the body. When latent, they are painless. But, through tension and overused, trigger points become activated. At this point, and over time, they become inflammed, and a source of pain. Really common areas to notice this are at the top of the shoulders, between the shoulder blades, and in the shoulder blades.

Activated Trigger points are present in chronic pain, overuse pain, and sports injuries. Cases of tendonitis and bursits, for example, while usually due to overuse, develop because of chronic shortening of the muscles and fascia. The muscles and fascia become “locked short.” The lock is the trigger point. The key to unlocking the trigger point is the Dry Needle or Acupuncture needle used in Dry Needling. When you “deactivate” a trigger point with a needle, any needle (Sir William Osler used hat pins in the 19th century into the piriformis trigger point) the muscles and fascia return to their normal legnth, which gives a chance for the bursa and tendons to heal.

Releasing Trigger Points with Dry Needling “deactivates” them and gives fast relief of Neck and Shoulder Pain, Back Pain, IT Band Pain, Acute and Chronic Sports Injuries, Tendinitis, Foot Pain, Rotator Cuff Pain, Forearm Pain Carpal Tunnel,Tension and Migraine Headache, and TMJ

 

What Does Trigger Point Pain Feel Like?

Trigger points are specialized tissue bundles. Also referred to as TrPs or “TPs”, trigger points are present in everyone’s muscles and fascia. Normally they are latent, or inactive. With overuse, chronic tension, or injury, trigger points become “activated” and painful. This can be called “trigger point pain”. It can be very severe. Trigger point pain can feel like you are being stabbed, it can be burning, it can even keep you up nights.

Trigger point pain can even mimic nerve pain, because it has a painful core that radiates outward. This is often the case when people feel they have Sciatic Pain. Trigger points in the buttock and hamstring can cause intense burning pain to radiate down the leg.

Another example are those pesky trigger points we get between our shoulder blades. I find these in 90% of my neck pain, shoulder pain, headache patients. When I press on those points it radiates pain up into the shoulder and neck.

 

Nerve Entrapment Syndromes and Motor Point Release

Nerve entrapment syndromes are when a nerve is compressed by tight muscles and fascia. This can happen anywhere in the body. Common areas are in the neck, shoulder, forearms, buttocks, and legs.

Our nerves flow like water in a hose. Muscle and fascia that are shortened from overuse, tension, and injury compress the nerve. The nerves often pass between muscles. This is as if someone were standing on the hose. It obstructs the flow of water. Worse, a single nerve, can be compressed in two or three places along its pathway. This translates into pain. If the entrapment continues over time it develops into numbness, tingling, and eventually weakness.

Motor Points and the Shortening of Normal Muscles

Motor points are specialized tissues in the muscles. They are where the nerve tells the muscle what to do, whether to contract or relax. Muscles work by shortening. Normally they shorten with activity, like a biceps curl, and return to their normal length when you stop. But with tension, overuse, or injury, your muscles are left in shortened positions. This is how pain begins.

The innocent evil genius of this process is the motor point. Each muscle has one. Its job is to order the muscle around and tell it what to do–contract, relax, contract, relax. Inside the motor point is a spindle. With tension, overuse, and injury the spindle gets contracted. This contracted spindle is what keeps your muscle in a shortened painful condition.

When I stimulate the spindle of the motor point with the dry needle, the motor point twitches, and the entire muscle then relaxes, which means it lengthens. The nerve is no longer entrapped, and normal nerve signals resume. Numbness, tingling, and pain go away.

When I dry needle for nerve entrapment I release the motor point of the muscle that is entrapping the nerve. I do this by inserting the needle into the motor point and moving the needle gently in an up and down motion. I may change the angle of the needle as I go to get different motor point fibers. Sometimes I even use two needles at once. I place one needle perpendicular to the skin, and the other at a 45 degree angle. This way I get different motor fibers at the same time.

Then I let you rest for a few minutes. This is because after your body relaxes for a while, then I can stimulate the needle a second time. This is often when I get the most profound release. It gives an even better result. In some cases where the person is very developed, and extremely tight, I left them relax again and stimulate one more time as I remove the needles.

Where are Trigger Points Located and How Do I Find Them?

Trigger points are found in the muscles, the fascia, even on blood vessels and on the surface of bones. They have predictable anatomical locations we learn by study and experience. The trigger points in the muscles and fascia are the cause of most Chronic Pain. They play a huge role in Sports Injuries. They play a major role headache pain. Trigger Points are associated with tight muscles and exquisitely tender focal points. When you press on trigger points they hurt, but it usually “hurts good.” When you dry needle these points, they stop hurting completely. When you release motor points along with trigger points you treat both the cause and the result of short, tight muscles.

Acupuncture Vs. Dry Needling

The most effective treatment for trigger points is Dry Needling. Its a physical method that changes muscle tissue immediately. It works directly on the muscles and fascia where the pain is.  Motor nerves tell the muscles and fascia what to do. Stimulating the muscle spindle of motor points causes muscles and fascia to lengthen and return to their original anatomical position. This facilitates more effective stretching and strengthening.  Pioneered by Janet Travell, M.D., Dry Needling is based on Western anatomy and physiology, and involves learning the locations of Motor Points and Trigger points in the muscles and fascia.

Acupuncture, on the other hand,  is based on the study of how Qi flows thru the Acupuncture Channels, or “Meridians.” There are 365 major acupuncture point locations we learn and needle in our practice. Acupuncture points are where biological energies from deep inside the body rises to the surface. That is why all our acupuncture points are found on the skin. Whereas dry needling works on the motor nerves that go from the brain to the muscles , Acupuncture works via the sensory nerves that travel back in the other direction.

Needle Technique in Dry Needling

Dry Needling is “Physical Medicine”, like Physical Therapy, Chiropractic, and Deep Tissue Bodywork therapies, such as Active Release (ART). While acupuncture technique can range from so light you don’t feel anything, to a dull achey feeling at the needle site, dry needle technique produces a muscle twitch response, called fasiculation. We stimulate your trigger point to produce this fasiculation. The more we stimulate it, the more it releases. This is a physical method, the equivalent of Deep Tissue massage versus light Swedish massage. We place the needle in the trigger point and use it the way a skilled bodyworker uses her fingers.

This muscle twitch response or fasiculation is your trigger point deactivating and the motor point stimulating the muscle to release and lengthen. It feels really good, though sometimes you do have to breath through it. Your whole body relaxes immediately and when done your pain is either gone or much better. Your muscles feel loose.

 

What is Fascia?

Fascia is a “band or sheet of connective tissue, primarily collagen, beneath the skin that attaches, stabilizes, encloses, and separates muscles and other internal organs.” Fascia is a kind of connective tissue, similar to tendons and ligaments, that have enormous elastic properties. Fascial tissue works with muscles to move bones, and also reduce the friction that occurs when muscles contract and release. In doing this the fascia has a protective for the nerves and blood vessels that lie within the muscles.

These bands of connective tissue organize our muscles and help the brain instruct the muscles on contraction and relaxation. What’s really cool is that there are bands of fascia that organize individual muscles, like the muscles in your thumb, but there are also larger bands of fascia that begin in the neck, that overlap the muscles of the entire arm, from the neck to the fingertips. We call these band “fascial trains.” If you want to understand your fascia, a good place to start is the book Fascial Trains, by Myers.

The Brain, Motor Points, Fasica, Muscle

When you do a biceps curl, here is a summary of what is happeng.

• You first decide consciously (at the gym) or unconsciously (the sudden need to fight off a mountain lion or man)  to curl the biceps
• Brain sends signal to the motor point of the biceps, via the motor nerve that enters the biceps at the “myoneural unit”, to contract
• Motor Point contracts and now signals to fascia and muscle to contract. Trigger points activate in the process to aid contraction
• You finish your workout, or fight off the mountain lion, now, your brain, via both the motor nerve and parasympathetic relaxation response, send chemical messengers to motor point, fascia, muscles, trigger point, to unwind and return to normal

 

Motor Points and Trigger Points

Dry Needling Trigger Points

Trigger points are areas of localized inflamation that can be very painful locally, but can also mimic nerve pain and radiate through the body…They are associated with fascial pain and can even be a source of “mysterious” abdominal pain, due to adhesions in the fascia…Dry needling can release these adhesions by deactivating trigger points in the abdominal muscles

Motor Points and Dry Needling

Dry Needling is also used to stimulate motor points. Stimulating motor points with dry needling causes tight, shortened muscles and fascia to return to their normal length.

With injury and chronic tension, fascia becomes a source of pain. The fascial sheath that encapsulates your individual groups of muscle fiber within a muscle becomes too stiff, or too mobile, or when it develops adhesions and fibrositis. And example of a fibrositic nodule associated with chronic tension are those lumps people get at the top fo their shoulders in the upper trapezius.

There is a lot more to fascia as well. Fascial tissue, like muscular tissue has a kind of primitive memory. This is why muscle change with poor posture and bad ergonomics. The fascia helps the muscle remember what to be like, whether to be relaxed (lengthened) or tense (shortened). Chronic shortened fascia plays a role in injuries from ligament sprains in athletes to herniated discs in desk jockeys.

 

 

 

 

 

Motor Points and the Shortening of Normal Muscles

Motor points are specialized tissues in the muscles. They are where the nerve tells the muscle what to do, whether to contract or relax. Muscles work by shortening. Normally they shorten with activity, like a biceps curl, and return to their normal length when you stop. But with tension, overuse, or injury, your muscles are left in shortened positions. This is how pain begins.

The innocent evil genius of this process is the motor point. Each muscle has one. Its job is to order the muscle around and tell it what to do–contract, relax, contract, relax. Inside the motor point is a spindle. With tension, overuse, and injury the spindle gets contracted. This contracted spindle is what keeps your muscle in a shortened painful condition.

When I stimulate the spindle of the motor point with the dry needle, the motor point twitches, and the entire muscle then relaxes, which means it lengthens. The nerve is no longer entrapped, and normal nerve signals resume. Numbness, tingling, and pain go away.

When I dry needle for nerve entrapment I release the motor point of the muscle that is entrapping the nerve. I do this by inserting the needle into the motor point and moving the needle gently in an up and down motion. I may change the angle of the needle as I go to get different motor point fibers. Sometimes I even use two needles at once. I place one needle perpendicular to the skin, and the other at a 45 degree angle. This way I get different motor fibers at the same time.

Then I let you rest for a few minutes. This is because after your body relaxes for a while, then I can stimulate the needle a second time. This is often when I get the most profound release. It gives an even better result. In some cases where the person is very developed, and extremely tight, I left them relax again and stimulate one more time as I remove the needles.

Nerve Entrapment Syndromes and Motor Point Release

Nerve entrapment syndromes are when a nerve is compressed by tight muscles and fascia. This can happen anywhere in the body. Common areas are in the neck, shoulder, forearms, buttocks, and legs.

Our nerves flow like water in a hose. Muscle and fascia that are shortened from overuse, tension, and injury compress the nerve. The nerves often pass between muscles. This is as if someone were standing on the hose. It obstructs the flow of water. Worse, a single nerve, can be compressed in two or three places along its pathway. This translates into pain. If the entrapment continues over time it develops into numbness, tingling, and eventually weakness.