Recently, 20 physical therapists with Northern Arizona Healthcare’s EntireCare Rehab & Sports Medicine department were trained in dry needling technique, or DNT. Now, dry needling is available at all six EntireCare locations throughout Flagstaff and the Verde Valley.
DNT and trigger point therapy are growing in popularity because of their effect on neuromuscular pain, soft tissue dysfunction and movement impairments; most commonly shoulder, back and fascial pain. DNT is also used to treat tension-type headaches
Trigger points are tender, hyperirritable spots within a tight, taut band of muscle fibers which, when stimulated, produce local and/or referred pain in skin, tendons, fascia, ligaments, joint capsules, periosteum and scars. Muscle dysfunction begins with overuse, overstretch and overload. These often cause trigger points in the body tissue, which in turn cause muscle pain or weakness.
Soft tissue dysfunction includes inflammation, shortening or contracture of soft tissue, trigger points, edema, trophic deficiencies, adhesions, scarring and biomechanical imbalances. DNT can help accelerate the healing rate as well as decrease the amount of inflammatory chemicals in the muscle tissue, increase mitochondrial production, and improve muscle strength and muscle length.
Dry needling is approved by the American Physical Therapy Association, or APTA. The therapist uses a thin-gauged, narrow filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, nerves, muscle tissue and connective tissue. This changes the patient’s awareness of sensation by stimulating nerves to send signals to the brain. Then the brain and spinal cord work to relax the targeted muscle. This relaxation, as well as improved circulation, makes it less likely for a muscle spasm to progress into a trigger point. It also accelerates soft tissue healing in many common injuries.
This is different from “wet needling,” when a healthcare provider uses a larger-gauged needle to provide an injection. It is also less painful, and the most common side effects can include a day of soreness and the possibility of a small bruise. However people who have a severe fear of needles are generally poor candidates for this treatment, as their anxiety overrides the positive effects of the needling.
In order to practice DNT, physical therapists must attend special continuing education courses after practicing for at least one year. These courses must meet high educational and safety standards.
DNT can help:
- Treat excessive muscle tension and trigger points, scar tissue, fascia and connective tissue
- Flush out inflammatory chemicals from the muscle
- Speed healing rate
- Decrease pain
- Improve range of motion
- Increase circulation
- Ease compression on joints by decreasing muscle tightness
- Provides neuromuscular re-education to poorly activated muscle tissue
- Re-educates muscle tissue to function more normally
Article was written by Melissa Felder, P.T., D.P.T., a physical therapist with Northern Arizona Healthcare’s EntireCare Rehab department. She is located at Flagstaff Medical Center. Melissa specializes in back and neck pain. She has extensive training in joint mobilization and manipulation, as well as in manual therapy for musculoskeletal pain. In addition, she specializes in dry needling, a treatment using a thin filament needle to decrease muscular pain. Her vast experience and training enable her to clearly and quickly recognize a variety of diagnoses and implement the appropriate treatment for a faster, holistic recovery. Melissa has been in the field of physical therapy since 1997.