Dry Needling for Myofascial Trigger Points
What are Trigger Points?
Trigger points are located in taut bands of muscle that can cause local and referred pain. They are a constant source of painful input into the brain increasing the sensitivity of the whole nervous system to painful stimuli. As well trigger points can cause weakness in the muscles they are located and contribute to abnormal movement patterns.
What Causes Trigger Points?
Mechanical Stress –Most common cause of trigger points, a sudden load to a muscle can cause trigger points to develop. Body asymmetry ie leg length difference, short upper arms in people who sit all day. Stress due to poor posture or repetitive movements. The weight of a purse or back pack on muscles, poor fitting clothing can cause constriction of the muscles leading to trigger points.
Nutritional Deficiency – Chronic mysofascial pain syndromes can be related to deficiency in vitamins and minerals which can cause impairment of energy and cell metabolism. Important vitamins and minerals include B1, B6, B12, Folic Acid, Vitamin C, Calcium, Magnesium, Potassium and Iron
Metabolic/Endocrine Disorders – Hypothyroidism, hypoglycemia, hyperurecemia and pre and post menopausal conditions can contribute to trigger point development
Infections- Viral , bacteria or yeast can aggravate trigger points.
Psychological Factors and Stress-Depression, anxiety, insomnia, tension and fatique can result in a decrease in brain serotonin which causes increased sensitivity to pain
Allergies -can cause trigger points may be due to histamine release
WHAT IS DRY NEEDLING FOR TRIGGER POINTS
Treatment by dry needling is a technique where sterile disposable needles are inserted into trigger points in a muscle. The dry needling not only affects the taut muscle fibers but alters the chemical environment resulting in muscle relaxation. A local twitch response from needling the trigger points decreases activity of the nerves supply the muscle causing muscle relaxation locally and decreases overall widespread pain and sensitivity by altering messages to the brain
GOKAVI TRANSVERSE TECHNIQUE OF DRY NEEDLING
The Gokavi Transverse Technique is a way of dry needling which has been developed to decrease the pain of needling that was experienced in the original technique of dry needling developed by Dr Gunn (where the needle is inserted perpendicular to the muscle fibres) In the Gokavi technique the area is first treated with an electrical stimulation causing analgesia in the area and relaxation of the muscles. Then the triggers points are lifted and needled transversely.
WHAT CAN I EXPECT FROM THE TREATMENT?
The initial assessment will take approximately 45-60 minutes as a thorough assessment of the painful area will take place and then treatment. Follow up treatment times last approximately 30-45 minutes
Patients are encouraged to have a light meal prior to needling.
Some individuals may experience post treatment soreness for 1-2 days. A warm bath following treatment can alleviate the symptoms.
Even if the pain is resolved following treatment aggressive exercise should be avoided but stretching of the tight muscles is encouraged.