Physical Therapy of Plano. Matthew Infanzon, PT, OCS, CSCS.Physical Therapy of Plano. Matthew Infanzon, PT, OCS, CSCS.

Trigger Point Dry Needling (TDN)

Trigger Point Dry Needling or TDN is a treatment for relieving pain caused by myofascial trigger points. Myofascial trigger points are irritable spots in the muscle that are associated with a hypersensitive palpable nodule in a taut band (Simons, Travell and Simons, 1999). In other words, a painful spot in the muscle that when pressed, will send pain to a different area, called a referral pattern. For example, pressing the muscle at the base of the neck can send pain into the head.

Dry needling is the insertion of a very small, fine needle into the trigger point to release the tight muscle and stimulate the body’s system for healing. The needles used are much smaller than injection needles and have a rounded, solid tip versus the beveled, hollow tip of an injection needle; so there is very little risk of adverse tissue damage or infection with TDN and often less discomfort than experienced with a traditional injection. The patient will often experience a small prick or pinch as the needle goes through the skin followed by a deep ache or cramping sensation and often a twitch as the needle reaches that targeted point and the muscle releases. This can be followed by muscle soreness after treatment that is similar to that experienced after exercising. Treatment soreness will usually not last for more than one day.

Who benefits from Trigger Point Dry Needling?

TDN can be used on a variety of patients to treat back pain, neck pain, shoulder injuries, knee injuries, etc. It can even be used for those who have had surgery.

Dry needling is a great technique to decrease the pain from muscles, and by relaxing the muscles we are then able to treat the joints more effectively. This allows exercise to be performed more effectively and the pain cycle can be broken. It is a great tool for us to have and the results can be dramatic.

What effect does TDN have on the muscle?

  • Increased blood flow which brings improved nutrition and oxygen to the muscle for healing
  • Decreased muscle banding—TDN stimulates the tight band of muscle which is followed by relaxation of the muscle. This alleviates biomechanical strain on adjacent joints and when coupled with other manual techniques and therapeutic exercise helps to normalize muscle and joint function.
  • Decreased abnormal neurological energy-eliciting the twitch response through needling has been found to quiet spontaneous electrical activity of nerves in trigger points (Chen et. Al, 2001).
  • Decreased pain—There is evidence that the twitch response can normalize the balance of chemicals responsible for the transmission of pain from trigger points in muscle (Shah,, 2005). It is also thought that TDN may decrease pain through stimulation of complex pain pathways in the body.

Is TDN the same as acupuncture?

No, TDN is not the same. While the needles used are the same as in acupuncture, the methods of evaluation and needle placement are very different. In physical therapy practice, the clinician will use a complex evaluation of the joints, muscle, and neural systems to identify and treat dysfunction. Needle placement is based on problematic areas in the muscular system. An acupuncturist also uses many evaluation and treatment techniques, however, needle placement is usually determined by identifying points along meridians or energy channels of the body. Stimulation of these points is aimed at restoring the energy flow (or Chi) to promote healing.

If you have any questions about Trigger Point Dry Needling and to see if it is appropriate for you, please call our office at (972) 398-7881.