What exactly is Trigger Point “Dry Needling” Therapy?

It is like a massage but much deeper and the effects last a lot longer. – A.B.

At the risk of sounding pithy, trigger point therapy mostly involves “busting up knots” in malfunctioning muscles. Trigger points are tender spots that cause or refer pain to other parts of the body. When these trigger points are properly deactivated, the pain disappears and the muscles become stronger, often dramatically improving the range of motion in joints like the hip and shoulder.

One way to think about our muscles is how they are built like “hoses within hoses within hoses” (see image from Thieme Atlas of Anatomy) which slide against each other as the muscle contracts. Every now and then, one or more of those hoses get a “kink” from trauma or overuse (e.g. prolonged repetitive motion or sitting) meaning one or more muscle fibers cease to contract/uncontract properly. Eventually, these groups of malfunctioning muscle fibers become hard knots or tight bundles. Most people can find them in their neck and shoulders.

There’s no shortage of official-sounding definitions for “dry needling”, but this is what I tell my patients: when I hit a knot in just the right spot, the muscle fiber releases and resets which causes a twitch response, otherwise known as a “fasciculation”. Just like a garden hose that is unkinked and pops as the water suddenly rushes through, the patient will feel like a spring opened inside the muscle and there’s a release of pressure.

Why do it?

In my practice, I integrate this type of needling into acupuncture sessions, but I also do it as stand-alone dry needling sessions. The patients who benefit the most from this therapy suffer from long-term muscle dysfunction and have usually experienced temporary relief from other therapies like massage in the past.

I came to dry needling in the hope that it would provide a solution for tight muscles which never seemed able to release and muscle pain which never seemed to go away. Over the years I have tried everything: traditional Eastern medicine, physical therapy, massage, chiropractic, yoga, foam rollers, massage balls… the list goes on. And in spite of all of these therapies, my overall condition didn’t change and I continued to reinjure myself when tight muscles would go into spasm. I am happy to report that dry needling has turned out to be the solution I was looking for. It is really quite a remarkable sensation to feel the muscles release. And it is great to have painful muscles finally stop hurting. – J.A.