Dry Needling for the Treatment of Musculoskeletal Ailments With Trigger Points

Abstract

Background: Dry needling is an increasingly popular technique for relieving musculoskeletal pain, through targeting myofascial trigger points. Existing evidence indicates that dry needling is effective in short-term management of pain, with research showing efficacy in improving functional outcomes when compared to other treatments. Indications: Myofascial trigger points may result in range of motion limitations and muscle weakness. Noninvasive treatments for musculoskeletal pain associated with myofascial trigger points, such as stretching or warm compresses, may not provide significant benefit for patients. Dry needling is a minimally invasive technique that provides significant short-term functional improvement and analgesia for musculoskeletal pain associated with myofascial trigger points, seen with reductions in visual analog scale (VAS) pain scores and decreased need for pharmacologic therapies. Technique Description: This video demonstrates dry needling at the tensor fascia latae, extensor carpi radialis longus , and gastrocnemius muscles. Myofascial trigger points and important anatomical landmarks are identified and labeled. A needle is inserted into the region of the myofascial trigger point to a depth of 10 to 100 mm and remains in situ for about 10 to 20 seconds with the use of a piston technique, although this time varies dependent upon patient response. Results: Dry needling may significantly decrease pain and improve functional outcomes in patients with short-term musculoskeletal ailments. Randomized controlled trials have examined dry needling for fibromyalgia, mechanical neck pain, myofascial pain, and following total knee arthroplasty, with these finding significant reductions in pain scores in short-term follow-up. A randomized single-blind placebo-controlled trial found dry needling with exercise to be more effective than sham dry-needling and exercise. Dry needling may provide improved long-term analgesia but also results in increased pain during the procedure and increased soreness afterwards. Pain relief may not last beyond 6 months, although little research investigating long-term outcomes has been performed. Discussion/Conclusion: The usage of dry needling in clinical settings is increasing, as it has shown strong efficacy in providing short-term pain relief and ability to improve functional outcomes. Dry needling is a simple, minimally invasive technique that is easily and quickly learned by physical therapists and may provide great benefits to patients.