Physiological Effects of Dry Needling
Dry needling treatment
Exploring the Mechanisms Behind Dry Needling
Dry needling, a therapeutic intervention drawing insights from acupuncture, remains a subject of growing research interest, especially in its application for myofascial pain in acute and chronic low back pain. While the precise mechanisms of dry needling's effectiveness in deactivating trigger points are not fully understood, emerging research underscores its superiority in reducing pain intensity compared to other treatments.
Key Findings and Insights
Pain Intensity and Disability Reduction: Dry needling shows a significant reduction in pain intensity and disability post-intervention, surpassing other treatment modalities in efficacy.
Variable Long-Term Outcomes: Follow-up results vary, with some studies indicating lasting benefits while others show a reduction in effectiveness over time.
Enhanced Efficacy in Combination: Dry needling, when used alongside treatments like physical therapy, may enhance outcomes, particularly in pain disability.
Deeper Needling Has Different Effects: Needle depth affects the tissues reached and physiological responses of treatment.
Improvement in Spinal Mobility: There's evidence suggesting dry needling can increase spinal mobility measures and enhance the quality of life after treatment.
Addressing Different Aspects of Myofascial Pain
The effects of dry needling can be understood in the context of various aspects of myofascial trigger points (MTrPs) pathology:
Taut Band: While the mechanical disruption of dysfunctional endplates is a common hypothesis, recent studies have not conclusively demonstrated this mechanism.
Blood Flow Enhancement: Needling may increase blood flow and oxygenation in muscles, with several studies suggesting the release of vasoactive substances as a plausible explanation.
Peripheral Sensitization: Research indicates that dry needling can reduce concentrations of substances like Substance P (SP) and Calcitonin Gene-Related Peptide (CGRP), which are higher around active MTrPs.
Neurophysiological Impacts: The technique may also influence pain processing at both peripheral and central levels, with studies noting variations in SP levels and other inflammatory markers post-needling.
Clinical Implications and Future Directions
The findings of these studies point towards dry needling as a promising approach for myofascial pain, particularly in cases where traditional pharmacological treatments are not viable. Its ability to influence muscle tissue, blood flow, and neurophysiological responses makes it a valuable tool in pain management. However, further research is needed, especially regarding the long-term effects and the mechanistic pathways through which dry needling exerts its therapeutic benefits.
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Sources:
Travell, J. G., Simons, D. G. (1993). Myofascial pain and dysfunction: The trigger point manual. London: Lippincott Williams & Wilkins.
Cagnie, B., Dewitte, V., Barbe, T., Timmermans, F., Delrue, N., & Meeus, M. (2013). Physiologic effects of dry needling. Current pain and headache reports, 17(8), 348. https://doi.org/10.1007/s11916-013-0348-5
Ceccherelli F, Rigoni MT, Gagliardi G, et al. Comparison of superficial and deep acupuncture in the treatment of lumbar myofascial pain: a double-blind randomized controlled study. Clin J Pain. 2002;18(3):149–53.
Cagnie, B., Barbe, T., De Ridder, E., Van Oosterwijck, J., Cools, A., & Danneels, L. (2012). The influence of dry needling of the trapezius muscle on muscle blood flow and oxygenation. Journal of manipulative and physiological therapeutics, 35(9), 685–691. https://doi.org/10.1016/j.jmpt.2012.10.005
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