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Dry Needling

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Krista Beaman

on 17 February 2016

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Transcript of Dry Needling

Evidence Summary
-Dry Needling performed better in alleviating
first-step pain and foot pain
in patients with plantar heel pain as compared to sham dry needling. (Cotchett et al., 2014)

-Dry Needling paired with MET used in female patients with
latent trigger point in the upper trapezius
decreases VAS pain, pain pressure threshold and increases ROM when compared to either treatment on its own. (Yeganah Lari et al., 2015)

-Dry Needling and stretching improves Cervical ROM in patients with
myofascial chronic neck pain
. (Campa-Moran et al., 2015)
The End!
Video Demonstration
Theory Behind
Dry Needling
Dry Needling can be used two different ways:

1) Treatment of myofascial trigger points (TpRs), which are hyperirritable taut bands of contracted skeletal muscle that produce local or referred pain when stimulated

2) Treatment of scar tissue, fascia, and connective tissue

Dry Needling: Getting to the Point
Dry Needling:
based on western neuroanatomy and modern scientific study of the musculoskeletal and nervous system (APTA, 2012)
Utilized With...
Indications for use
Acute/Chronic injuries
Neck/Back pain
Muscle Spasms
Hip/Knee pain
Muscle strains
Tennis/Golfer's Elbow
Other overuse injuries (shin splints, runner's knee, etc.)
Dry Needling vs. Acupuncture
-Deep Dry Needling of trigger points in the Lateral Pterygoid muscle as compared to methacarbomol medication(muscle relaxer) showed more of a decrease in pain and an increase in mandibular depression, lateral excursion, and protrusion for patients with
. (Gonzalez-Perez et al., 2015)

-The inclusion of trigger point Dry Needling of the lateral peroneus muscle into a strengthing/proprioception exercise group resulted in decreased pain and increased function in patients with
chronic ankle instability
. (Salom-Moreno et al., 2015)

-A single session of deep Dry Needling decreased spasticity and pressure sensitivity in patients with
spasticity due to stroke
. ( Salom-Moreno et al., 2014)
Uses a thin needle to penetrate the skin and stimulate myofascial trigger points as well as muscular and connective tissue to treat pain and movement impairments.
(APTA, 2013)
Myofascial Trigger Points (TrPs)
For TrPs, Dry Needling can be Deep or Superficial

Deep Dry Needling inactivates TrPs by causing local twitch responses.
These local Twitch responses are involuntary contractions of the taut band
Causes a decrease in spontaneous electrical activity, decrease in inflammation, immune system activity, and relaxation of the band
Results in increased ROM, decreased in TrPs irritability, decreased pain, and restored local circulation

Superficial Dry Needling activates mechanoreceptors to slow conducting unmyelinated C fiber afferents and stimulate A delta fibers

Superficial Dry Needling reduces local and referred pain and increases ROM but does not alter the body's chemical environment
Myofascial Trigger Points (TrPs)
Scar Tissue, Fascia, CT

Dry needling has been linked to affecting fibroblasts
Fibroblasts synthesize, organize, and remodel collagen

When stimulated by dry needling, fibroblasts increase their collagen synthesis and cell proliferation, as well as cytokines and inflammatory mediators to help reduce pain and stimulate change
based on preserving the
ancient theories and principles of traditional
Chinese medicine (APTA, 2012)
Can "redirect and reposition the flow of chi which is energy for the purpose of relieving tension, stress, and pain" (Miller, 2015)
1. Dry Needling in Physical Therapy. 2016. Available at: http://www.apta.org/StateIssues/DryNeedling/. Accessed February 11, 2016.
2. http://www.apta.org/StateIssues/DryNeedling/ResourcePaper/. Accessed February 11, 2016.
(APTA, 2013)
(APTA, 2013)
(APTA, 2013)
(APTA, 2013)
3. http://physioworks.com.au/treatments-1/acupuncture-and-dry-needling - (Miller 2015). Accessed February 11, 2016.
The only similarity is the use of similar needles (Miller, 2015)
YouTube. Dry Needling: Trapezius. 2016. Available at: Accessed February 7, 2016.
4. Cotchett, M. P., Munteanu, S. E., & Landorf, K. B. (2014). Effectiveness of Trigger Point Dry Needling for Plantar Heel Pain: A Randomized Controlled Trial. Physical Therapy, 94(8), 1083-1094
5. Campa-Moran I, Rey-Gudin E, Fernández-Carnero J, et al. Comparison of Dry Needling versus Orthopedic Manual Therapy in Patients with Myofascial Chronic Neck Pain: A Single-Blind, Randomized Pilot Study. Pain Research and Treatment. 2015;2015:327-330.
6. Ameneh Yeganeh Lari, Farshad Okhovatia, Sedigheh sadat Naimi, Alireza Akbarzadeh Baghban. The effect of the combination of dry needling and MET on latent trigger point upper trapezius in females. Man Ther. 2016 Feb;21:204-209
7. Gonzalez-Perez LM, Infante-Cossio P, Granados-Nuñez M, Urresti-Lopez FJ. Treatment of temporomandibular myofascial pain with deep dry needling. Medicina Oral, Patología Oral y Cirugía Bucal. 2012;17(5):781-785.
8. Jaime Salom-Moreno, Blanca Ayuso-Casado, Beatriz Tamaral-Costa, Zacarías Sánchez-Milá, César Fernández-de-las-Peñas, and Francisco Alburquerque-Sendín, “Trigger Point Dry Needling and Proprioceptive Exercises for the Management of Chronic Ankle Instability: A Randomized Clinical Trial,” Evidence-Based Complementary and Alternative Medicine, vol. 2015,9 pages, 2015.
9. Salom-Moreno J, Sánchez-Mila Z, Ortega-Santiago R, Palacios-Ceña M, Truyol-Domínguez S, Fernández-de-las-Peñas C. Changes in spasticity, widespread pressure pain sensitivity, and baropodometry after the application of dry needling in patients who have had a stroke: a randomized control trial. J Manipulative Physiol Ther. 2014 Oct;37(8):569-579.
Patient Selection
Nearly all patients who present with indications for dry needling
Not recommended for children under 12
Needle aversion or phobia
Significant cognitive impairment
Need to be able to give consent
Local or systemic infections
(APTA, 2013)
(Ries, 2015)
10. Available at: http://www.neurosportphysicaltherapy.com/services/dry-needling. Accessed February 11, 2016.
11. Ries, E. Dry Needling: Getting to the Point. Dry Needling: Getting to the Point. 2015. Available at: https://www.apta.org/ptinmotion/2015/5/dryneedling/. Accessed February 12, 2016.
Krista Beaman, Alissa Foote, Austin LeForce, Kelsey Spangler
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