At Spine Plus we provide specialist (Medical) Acupuncture therapy from our team of osteopaths and physiotherapists in London, focusing on the myofascial pain and trigger points (trigger point dry needling). In addition Osteopathy and Physiotherapy both involve manual manipulation of the body, together with exercise and lifestyle advice, to help with a range of conditions such as back pain, rehabilitation from orthopaedic surgery, whiplash, repetitive strain (RSI) and sports injuries.
About Trigger Point Dry Needling – Medical Acupuncture
One of the distinguishing features of our therapists is that they are all trained in acupuncture including trigger point dry needling (medical acupuncture) and acupressure (which can use if preferred by the patient). This can be highly effective for relieving painful muscle knots called trigger points. Trigger points form tight bands or knots in muscle tissue which are often a major component of persistent or chronic conditions such as chronic back pain, tension headaches and other “referred pain” conditions.
A very common area for trigger points to occur is in the muscle in the top of your shoulder. This trigger point usually causes referred pain to the head and neck and restricted movement of the neck.
Other common areas for trigger points to form are in the deep gluteal muscles around the hip. These can cause pain all the way down the leg which can be mistaken for, or co-exist with, “sciatica” pain from a trapped nerve in the lower back.
Pain killers can help mask the symptoms but within a trigger point there is usually spontaneous electrical activity causing the fibres to be permanently contracted. Consciously trying to relax the area, stretching, massaging and even taking muscle relaxant medication will often not be enough to make the knot “let go”. In fact some forms of massage and stretching can even make the tension worse by irritating the sensitive nerve endings within the trigger points.
What therapies exist to relieve trigger points?
Some pain doctors use injections to relieve trigger points. This involves using a hypodermic needle to inject various medications such as local anaesthetic, cortico-steroid or Botox. However complications may occur due to the drugs used and as well as being relatively expensive there is often a limit on the number of times these procedures can be used. It has been found in research studies that people improve when needles are inserted in trigger points, no matter what substance is injected, or even if nothing is injected (dry needling). Therefore, it is often the effect of the needle that helps, not the medication injected.
How does trigger point dry needling work?
Dry needling works by promoting blood flow and reducing the spontaneous electrical activity within the trigger points and by stimulating the body to release growth factors that promote healing. Dry needling also offers several advantages over injections, no medication is involved so there are less side effects, it is a lot cheaper to perform and can repeated however many times is required.
Dry needling can be performed once or twice a week initially before the intervals are extended, a typical course takes between 3 and 12 sessions of dry needling. In the case of stubborn Trigger Points that do not fully respond to dry needling we may refer for injections.
Dry Needling versus Traditional Acupuncture
Trigger point dry needling is sometimes referred to as medical acupuncture. However, dry needling is quite different from traditional acupuncture. With dry needling there is no intention of affecting energy meridians. Dry needling is based on modern science and knowledge of anatomy and physiology.
What does dry needling feel like?
You may feel nothing at all when the needle is first inserted. When the needle contacts the trigger point it should cause a “twitch response”. The twitch response is a momentary contraction of the muscle. It may just be a mild twitch, or it may feel like a “cramping” of the muscle. You might also experience referred pain in a distant area of your body. This is a good thing, especially if it’s a “familiar” pain for you. This means that we’ve needled an active trigger point which is causing some of your symptoms.
The twitch response is usually a strong indicator of a successful treatment, the stronger the twitch the better the improvement will usually be after. The area may feel mildly bruised for a day or so and it may take up 48 hours to feel the full improvement.
Is needling safe?
Dry needling is a safe procedure, though there are some potential risks. We use every precaution to minimize these risks. The most serious complication which could occur is a puncture of the lung if needling around the chest wall (thorax). If this happened, it may only require a chest x-ray and no further treatment. Symptoms of shortness of breath may last for several days or weeks. A more severe lung puncture may require hospitalization and re-inflation of the lung. Thankfully the risk of a lung puncture is very low and in skilled hands should not be a concern, however the guidelines rightly dictate you should be aware of this risk before consenting to treatment.
Other complications include causing a bruise. Bruises occasionally occur but they should not be a concern unless you are taking blood thinning medication such as warfarin. The needles we use are all sterile single use needles, so the risk of infection is negligible. Unlike syringe needles the needles used for dry needling are very small and do not have a cutting edge, therefore the likelihood of any significant tissue trauma is very small.
Don’t like the idea of needles? It’s OK Trigger Points can also be treated using the advance soft tissue massage techniques performed by our osteopaths and massage therapists, click here for more info:
Why Spine Plus?
One of our hallmarks is that our osteopaths use medical acupuncture / acupressure, alongside traditional treatment. We have found medical acupuncture to be particularly effective when combined with traditional osteopathic / physiotherapy manual treatment. This requires additional postgraduate training which they have all undertaken. Also, our physiotherapists andosteopaths are trained in the use of electrotherapy, such as ultrasound, which can be very useful for certain ligament and tendon problems. This means our osteopaths and physiotherapists have all the necessary skills and abilities to provide the gold standard of treatment.