The Beginning of Dry Needling

Wed, 23 Jul 2008

Dry Needling is gaining recognition in the circles of physical therapists and their patients around the globe. Dr. Amaro takes a look at some of the beginnings of "Dry Needling" for ChroniWeb.com and when it came to his attention:

In 1970, upon my return to civilian duty after serving in the U.S. Army as a combat medic, I became one of the first newly formed paramedics in the nation while trying to earn enough money to afford to enter into practice. As a result of my interest in emergency medicine, I would read the medical journals lying around the station on a regular basis. To this day, I recall one particular article that caught my attention, and I have thought about often.

The article focused on the administration of saline or magnesium sulfate for acute (or chronic) hip pain via hypodermic needle injection into a precise location on the hip. The article went into great detail, describing exactly where the injection spot was to be made. This was done with the use of explicit drawings of the musculature and skeletal relationship of the pelvis. The article further elaborated that it was essential to hit precisely the exact spot to avoid injecting into any other location, which would not yield the same outstanding clinical response experienced by other practitioners. The precise location described is what is known in acupuncture as “GB30” (huan tiao).

When a medical physician injects local anesthetic, saline, corticosteroids or other agents into a trigger point or known acupuncture point, it is medically referred to as trigger-point injection. However, when the same practitioner utilizes a needle into the same precise point without the administration of a substance, it is globally referred to as “dry needling.” The term wet needling does not exist – it is simply known as trigger-point injection therapy.

Trigger points (TrPs), described by Drs. Travell and Simons in the mid-1960s, are hyperirritable spots in skeletal muscle that are painful on deep palpation and give rise to referred pain and motor dysfunction. They are found in palpable, taut bands of skeletal muscle. They are extremely sensitive to palpation and will produce referred pain for the associated muscle, and are often remote from the TrP itself. The most frequently affected sites are the trapezius, supraspinatus, infraspinatus, teres major, lumbar paraspinals, and gluteal and pectoralis muscles. Myofascial pain syndromes are regional, painful muscle conditions with a direct relationship between specific trigger points and their associated pain region. They are commonly seen in both acute and chronic pain conditions. It has been said that myofascial trigger points are the most commonly missed diagnosis in chronic pain patients.

Continue reading "When Acupuncture Becomes Dry Needling" on ChroniWeb.com