Acupuncture & Dry Needling

with Dr. Mac

What is the difference between Acupuncture & Dry Needling?

As the name implies, no solutions are being injected. Both of these therapies are ‘dry’. Thin filiform needles that are thin enough for comfort, but thick enough for safety and effectiveness are utilized for both acupuncture and dry needling.

According to Johns Hopkins Medicine, “Acupuncture is the practice of penetrating the skin with thin, solid, metallic needles which are then activated through gently and specific movements of the practitioner’s hands or with electrical stimulation. Acupuncture is part of the ancient practice of Traditional Chinese Medicine.” The location for needle insertion is based upon examination and the Meridian pathways providing local and systemic benefit.

Dry needling is an effective therapy to treat muscular tension and spasm which commonly accompanies conditions including but not limited to: muscular strains, arthritis, nerve irritation, muscular tension, ligament sprains, or herniated discs. The location for needle insertion is based upon examination including palpation to determine areas of tension, injury, and/or pain.

More on Dry Needling

Whether injury occurs from repetitive use or acute trauma, inflammation is produced from damaged tissue. Naturally the body responds to damaged tissue by going into protective mode producing tension, contracture, or spasm. The combination of spasm with inflammation reduce the ability of oxygen-rich blood and nutrients to reach the site of injury and for waste products to flush out. Due to the state of decreased oxygenation and increased waste build up, the body produces scarring in the area. Scarring within a muscle inhibits its ability to function to full capacity, ie reducing its ability to both lengthen into extension and shorten into contraction. Scarring of tissues can also compress and irritate nerves and other structures around it. All of which together produce pain and decreased function.

Needle insertion into or near these fibrotic areas breaks up the pain-tension cycle by first stimulating the muscle, tendion, or fascia with the goal of producing a local twitch response. The local twitch response has been shown in research to decrease muscle contraction, redue chemical irritation, improve extensibility, and decrease pain.

A controlled lesion is also produced with needle insertion cutting between three to fifteen thousand individual muscle fibers. From this, the body activates an immune system response to the area bringing in nutrients, oxygenated blood, and specific cells to clean up waste.

MECHANICAL EFFECTS OF Dry Needling

  • Dry Needling may mechanically disrupt a dysfunctional motor endplate.

  • Needling results in a Local Twitch Response (LTR)

  • The LTR results in an alteration to muscle fiber length as well as having an inhibitory effect on antagonistic muscles

NEUROPHYSIOLOGICAL EFFECTS OF Dry NEedling

  • Baldry (2001) suggests that dry needling techniques stimulate A-nerve fibers (group III) for as long as 72 hours post needling

  • Prolonged stimulation of the sensory afferent A-fibers may activate the enkephalinergic inhibitory dorsal horn interneurons, which implies that dry needling causes opioid-mediated pain suppression

  • Another possible mechanism of dry needling is the activation of descending inhibitory systems which would block noxious stimulus into the dorsal horn

  • The LTR may also utilize the excessive ACh in the tissue which previously was triggering increased firing of localized fibers

CHEMICAL EFFECTS

  • Studies by Shah and colleagues (2001) demonstrated increased levels of various chemicals at sensitized motor end plates such as Bradykinin, Substance P, and CGRP (regulator of Calcium and Phosphate balance). These chemicals were reduced immediately post an LTR.

  • CGRP enhances the release of ACh from nerve terminals, which results in increased ACh receptors at the neuromuscular junction

  • Needle penetration will cause micro-trauma and micro bleeding (localized inflammation) and hence the introduction of PDGF into the area to help promote healing

What can Acupuncture or Dry Needling assist?

Conditions:

  • Neck/Back Pain

  • Shoulder Pain

  • Tennis or Golfer’s Elbow

  • Headaches/Migraines

  • Hip and Gluteal Pain

  • Knee Pain

  • Achilles Tendonitis/Tendonosis

  • Plantar Fasciitis

  • Sciatica

  • Muscular Strains/Ligament Sprains

  • Chronic Pain

  • Athletic Performance

  • Fibromyalgia

DOES needling HURT?

You may or may not feel the insertion of the needle. The specific needle manipulation is intended to produce a local twitch response that can elicit a very brief (less than a second) painful response some patients describe as a deep ache or cramping sensation.  Again, the therapeutic response occurs with the elicitation of the local twitch response and is a desirable reaction.

WHAT CAN I DO TO PREPARE FOR MY Treatment?

Eat a light meal 1-2 hours prior to your visit and wear loose, comfortable clothing that can be rolled up or down to access your areas of concern with the greatest ease.

WHAT CAN I EXPECT AFTER TREATMENT?

We are looking to get improvements even from the first visit such as increased range of motion, ease of movement and decreased signs/symptoms.

Many patients report being sore after the treatment in both the area treated and the area of referred symptoms.  Typically this soreness lasts between a few hours and two days and there is occasional bruising.  Soreness may be alleviated by applying ice or heat to the area and performing specific stretches for the treated muscle.

Value:

Acupuncture:

  • Pairs well with chiropractic care

  • Some Wellmark/BCBS policies cover acupuncture services

  • Examination is required for new acupuncture patients

  • Call or email to discuss insurance coverage and pricing

Dry Needling:

  • May be coupled with chiropractic, physical therapy or massage therapy care

  • NOT covered by insurance

  • Call or email to discuss pricing

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