Dry needling is the use of a solid needle for therapy. This contrasts with the use of a hollow hypodermic needle to inject substances such as saline solution to the same point. Such use of a solid needle has been found to be as effective as injection of substances in such cases as relief of pain in muscles and connective tissue. Analgesia produced by needling a pain spot has been called the needle effect.[1] "Dry needling" is in effect acupuncture by another name. [2]
In the treatment of trigger points for persons with myofascial pain syndrome, dry needling is an invasive procedure in which an acupuncture needle is inserted into the skin and muscle directly at a myofascial trigger point. A myofascial trigger point consists of multiple contraction knots, which are related to the production and maintenance of the pain cycle.[3] Proper dry needling of a myofascial trigger point will elicit a local twitch response (LTR), which is an involuntary spinal cord reflex in which the muscle fibers in the taut band of muscle contract. The LTR indicates the proper placement of the needle in a trigger point. Research has indicated that dry needling that elicits LTRs improves treatment outcomes. Dry needling is also referred to as "acupuncture." [4]
Dry needling is practiced by physical therapists in many countries, including South Africa, the Netherlands, Spain, Switzerland, Canada, Chile, Ireland, the United Kingdom and New Zealand . In the United States, physical therapists in several states including Virginia, Maryland, Ohio, Colorado,[5] Georgia, New Mexico, and Kentucky, perform the technique, although it has been and is currently being contested in many states.
A survey of acupuncture and dry needling for the treatment of chronic lower back pain concluded that they may be useful adjuncts to standard therapies. The quality of these studies indicated that higher quality of methodology is required before they can be recommended as a treatment modality.[6]
Comparison with acupuncture
Acupuncture has been defined as "...the insertion of a solid needle into any part of the human body for disease prevention, therapy or maintenance of health."[7] Dry needling is one of a number of needle techniques employed by Acupuncturists or Doctors of Traditional Chinese Medicine to acupoints or tender (ashi) points. [8]
References
- ^ K. Lewit (February 1979), "The needle effect in the relief of myofascial pain", Pain 6 (1): 83–90, doi:
- ^ http://www.acupuncturetoday.com/mpacms/at/article.php?id=30317
- ^ http://www.bethesdaphysiocare.com/pdf/faq_dryneedling.pdf
- ^ http://www.cochrane.org/reviews/en/ab001351.html
- ^ Colorado Physical Therapy LIcensure, Policy 30-2, Director's Policy on Intramuscular Stimulation, July 20, 2005, http://www.dora.state.co.us/physical-therapy/Policy30-2.pdf
- ^ Furlan AD, van Tulder MW, Cherkin DC, et al. (2005), "Acupuncture and dry-needling for low back pain", Cochrane database of systematic reviews (Online) (1): CD001351, doi:, PMID 15674876
- ^ The Statutory Regulation of the Acupuncture Profession, Acupuncture Regulatory Working Group, September 2003, http://www.ehpa.eu/pdf/ARWG_report_2003.pdf
- ^ http://www.cochrane.org/reviews/en/ab001351.html
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