Dry Needling Flashcards
what is a myofascial trigger point
a hyperirritable spot within a
taut band of skeletal muscle that is painful on compression, stretch,
overload, or contraction of the tissue which usually responds with a referred pain that is perceived distant from the spot.
active myofascial trigger point
those TrPs that upon
stimulation reproduce any symptom experienced by a patient, partially or
completely, and whereby the
reproduced symptom is recognized as a familiar experience by the patient
latent myofascial trigger point
clinically quiescent with
respect to spontaneous pain; it is painful only when palpated
integrated trigger point hypothesis
- increased Ach at synaptic cleft, changes in Ach receptor activity in number of receptors and down regulation of acetylcholinesterase
- muscle nociceptors become activated from release of ATP, bradykinin, 5-hydroxytryptamin, serotonin, prostaglandins, and K from muscle
- Nociceptor activation causes release CGRP from the motor nerve terminal and from the muscle nociceptors
- increased motor endplate activity
biochemical changes within active MTrP
- lower pH
- higher SP, CGRP. BK, norepi, 5-HT, tumor necrosis factor 1a and interleukin 1 compared with latent MTrPs and with normal control subjects
cinderella hypothesis
- Smaller motor units
fire first, and larger
motor units last - Larger motor units
turn off first, so
smaller motor units
can become overused
5 types of manual trigger point therapy
- trigger point compression
- trigger point pressure release/myofascial release
- manual techniques such as occipital release
- transverse friction massage
- spray and stretch
definition of dry needling
Dry needling is a skilled intervention using a thin filiform needle to
penetrate the skin that stimulates myofascial trigger points, musculature and connective tissue for the management of
neuromusculoskeletal disorders
what is a local twitch response
a brief and sudden contraction of a MTrP taut band with needle insertion; a spinal cord reflex
dry needling precautions
- needle aversion/phobia
- cognitive impairment
- cant give consent
- local skin lesion or wound
- local or systemic infection (except Lyme)
- local lymphedema
- following surgical procedure where capsule has been opened (THA,TKA)
- hyperalgesia or allodynia
- nickel or chromium allergy
- abnormal bleeding
- compromised immune system
DN contraindication
- 1st trimester of pregnancy
- vascular disease/varicose veins
- at level of laminectomy
- over abdomen in pregnancy
- over implant
- state practice act
post needling
- post needling soreness possible
for 24-48 hours - bruising possible
- avoid open water or potentially dirty water for 24-48 hours
- precautions with strenuous
exercise post needling (24 hours)
IL practice act for DN
- 1 year post DPT
- 30 hrs didactic work specific to intramuscular manual therapy
- 54 hours in intramuscular manual therapy opus work approved by FSBPT within 12 mo
- no retained needles or needle stimulation
- 200 documented patient treatment sessions with general supervision
needle size for quads
50-60mm
needle size for hammies
50-60mm
