Myofascial Trigger Point Dry Needling

Ryan Perry, PT, DPT, OCS, MTC, CSCS, FAAOMPT, CMTPT

NovaCare LogoHave you ever had a trigger point that never seems to go away?  There is nearly an unlimited supply of devices out there to work on trigger points, and I, along with many other runners, have tried most of them.  However, some trigger points can be very persistent and always seem to work their way back, sometimes even a few minutes later.  While many of the trigger point tools or devices work to apply compression or pressure to the periphery of a trigger point, Myofascial Trigger Point Dry Needling applies the stimulus to the trigger point directly, or within the trigger point.

By definition, Myofascial Trigger Points (MTrP) are hyperirritable spots in skeletal muscle that are associated with palpable nodules in taut bands of muscle fibers.  These can cause both local and referred pain.  The concept of Trigger Points had a modern day rediscovery in 1942 by Janet Travell, MD, who co-authored the book, Myofascial Pain and Dysfunction: The Trigger Point Manual, which is famous amongst physical therapists, massage therapists and sports medicine physicians.  She also happened to be the first female physician in the White House.

There is quite a bit of fascinating research on MTrPs, with some of the research being performed at the prestigious National Institutes of Health (NIH).  For instance, Shah et al performed research with micro-biopsy while performing MTrP Dry Needling, where the studies found a reduction in pain and inflammation generating cells, along with an improvement of the pH within the MTrP within minutes.  Other research studies have found improved outcomes with utilization of MTrP Dry Needling in randomized controlled trials compared to groups who did not receive it.

Myofascial Trigger Point Dry Needling is able to directly affect the MTrP since it is performed with a single filament needle that is very thin and it inserted directly into the MTrP.  The insertion of the needle through the skin is typically painless, however, the local twitch response that occurs with inserting the needle into the MTrP has discomfort similar to working the MTrP with a trigger point instrument.  There is one sterile needle used at a time, and it is typically moved in and out of the trigger point for 20 – 60 seconds, depending on the extent and location of the MTrP.

You may be asking why you have not heard of this?  Well, it has been performed by Physical Therapists for over 30 years in some states, mostly in the east coast; however it has been performed in Illinois by Physical Therapists for only the last four years.  Thus, it is relatively new, and only a small percentage of PTs perform this technique.  I have had many runners and triathletes have great responses with it, including triathletes who went on to complete an Ironman!  They were ready to give up on their training due to persistent pain, and PT with MTrP allowed them to return to running with significantly less pain.  If it were not for HIPAA / privacy acts, I would love to post the photos some of them sent me crossing the finish line!

As with any manual treatment, MTrP Dry Needling is only a component of PT. One must still address faulty biomechanics, muscle weakness, and flexibility deficits as well.  However, some of those issues may be related to MTrPs, and if so, MTrP Dry Needling can be of great benefit.

If you are interested in trying Myofascial Trigger Point Dry Needling, contact your local NovaCare clinic for availability. We offer Myofascial Trigger Point Dry Needling at the following locations:

Lincoln Square, 4657 N Lincoln Ave, Chicago, IL 60625 (773) 989-6472
Lincoln Park Athletic Club, 1002 W Diversey, Chicago, IL 60614 (773) 248-2578
Lakeview, 3240 N Halsted, Chicago, IL 60657  (773) 281-4220
Loop, 111 N Wabash Ave, Chicago, IL 60602 (312) 346-2539
Elmhurst, 275 North York Rd, Elmhurst, IL 60126 (630) 279-4852


Ryan Perry, PT, DPT, OCS, MTC, CSCS, FAAOMPT, CMTPT
www.novacare.com/chicagoland.htm
perryr1@novacare.com
NovaCare Chicagoland Continuing Education Leader
Center Manager for NovaCare in Lincoln Square
 
Lincoln Square
4657 N Lincoln Ave
Chicago, IL 60625
(P) 773-989-6472
(F) 773-989-6754

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