Dry Needling in Physiotherapy
Dry needling (DN) is an umbrella term encompassing different techniques that are performed using a thin, mono-filament dry needle inserted into a soft tissue.
Intramuscular stimulation (IMS) is a type of dry needling, which involves the insertion of the needle into a specific muscle with the goal of stimulating a twitch response. The needles are removed once the appropriate response is achieved, not left in the tissue like with acupuncture.
WHY?
While more research on DN is needed, it is used primarily to improve muscular recruitment, reduce pain, reduce nervous system sensitivity, and improve range of motion/ mobility. This is done with the intention of helping someone return to, or optimize, exercise and function! It is never the primary treatment, but rather a supplementary treatment to help achieve a goal.
WHAT is DN + ESTIM?
With this technique, the needle is inserted into the muscle or soft tissue and then a circuit is attached to the needles, allowing the tissues to be electrically stimulated. The output is similar to that of a TENs or muscle stimulation machine but under the skin vs on top.
Depending on the goal of the treatment, settings will vary. For example, with athletic recovery we are looking to create a muscle pumping effect, therefore a constant, low frequency setting would be used. For pain management, an alternating fast/ slow frequency would be used.
HOW does the addition of ESTIM help?
Has been shown to cause less soreness than dry needling alone (piston style)
Can be used to create a muscle pump action that may aid in muscle recovery
Electricity has been long studied in pain science (electroanalgesia) and can be more comfortable treatment than other DN techniques
Stimulates deeper tissue targets
Conditions commonly treated with DN
Tennis elbow
Rotator cuff strain
Upper trapezius tightness
Lower back pain/ stiffness
ITB pain (with the needling targeted at the hip muscles)
and many more!
To conclude, dry needling is an amazing addition to the vast tool box of a physiotherapist, and is a fantastic option for some clients to help release muscle tissue, reduce pain, and improve overall mobility on their rehabilitation journey.
Active treatment (e.g. exercise) will remain #1 in my books always, and any needling treatment will always be followed with a complimentary exercise targeted at the goal.
If dry needling is something you’ve been looking to try, all of the Pelvico physiotherapists are certified to perform this treatment and would be happy to see you!
