Medical acupuncture, or dry needling is a minimally invasive treatment whereby a very thin acupuncture needle is gently inserted into an area of muscle called a myofascial trigger point. This is a local, contracted, hyper-irritable band of muscle that can refer pain to other areas of the body and/or produce a local muscle twitch. These trigger points can sometimes be felt as pea-sized nodules of tissue, that can be uncomfortable to press into.

Myofascial pain is very common, and arises from muscles or related fascia (a continuous sheath of connective tissue that surrounds muscles, blood vessels, and nerves). Studies have shown that a overwhelmingly large percentage of people presenting with musculoskeletal pain will have mysofasical trigger points as their primary source of pain. This can often go undiagnosed, which can lead to chronic pain conditions.

Although an acupuncture needle is used to treat the trigger points, the therapy is generally based on the traditional thinking of Western medicine. However, some traditional Chinese acupuncture points may be used depending on the case, as this can produce a positive generalised response. It is a relatively new method of treatment, yet is now widely used by physicians. It is normally used in conjunction with the other techniques such as manipulation, stretching and massage.

The exact mechanisms of dry needling are unknown. There is a theory that the needle is identified by the body as a foreign object and therefore the area is targeted by local inflammatory mediators to ‘fight’ the unknown article and heal the area. It attracts the blood supply which helps flush out the tissue and provide nutrition to the tissue. The muscle will contract around the needle initially, then ‘let go’ and relax off, which indicates that the response has finished. Based on the pioneering studies by Dr. Jay Shah and colleagues at the National Institutes of Health, these biochemical and mechanical effects help to decrease pain levels overall. The endorphin release can also produce a feeling of euphoria and help numb the area.

Superficial dry needling is a relatively painless process. As opposed to deep dry needling, this technique involves inserting the needle into the fatty layer above the muscle. You may feel a little ‘abrasion’ as it pierces the skin surface but otherwise you may not feel a thing. The needle is very thin and pliable, like a hair so it tends not to pierce structures such as nerves and blood vessels and therefore tends not to draw blood – hence the term dry needling.

There is no statistical evidence to suggest that deep dry needling (where the needle is deeply inserted directly into the muscle) has any greater therapeutic benefit over the superficial method. However, in some cases the twitch response of deep dry needling may be a necessary reaction. Some describe this sensation as an electric shock and others describe it as more like a muscle cramp or dull ache. If elicited, this response will last less than a second. If I feel this is an appropriate method I will discuss this with you at the time, and explain why this may benefit your condition.