Dry Needling

Trigger Point Dry Needling Comes to Florida

The state of Florida recently updated the physical therapy practice act to include the performance of dry needling by physical therapists.  Dry needling has been performed by physical therapists in other states for many years, but it wasn’t until 2020 that physical therapists were able to perform this innovative procedure in Florida.  Physical therapists are only able to perform dry needling after they satisfy several statutory requirements which include:

  1. Physical therapist with 2 years of experience
  2. 50 hours of live continuing education specific to administering dry needling
  3. 25 supervised dry needling sessions
  4. letter of attestation to the state of Florida

What is trigger point dry needling?

Trigger point dry needling is an invasive procedure in which a solid filament needle is inserted into the skin and muscle directly at a myofascial trigger point.  Physical therapists at Synergy Health & Wellness utilize trigger point dry needling in the treatment of myofascial pain.   A myofascial trigger point consists of multiple contraction knots, which are related to the production and maintenance of the pain cycle.

How does trigger point dry needling work?

The exact mechanisms of trigger point dry needling are unknown.  We do know that inserting a needle into trigger points can cause favorable biochemical changes that assist in reducing pain.  According to the studies by Dr. Jay Shah and colleagues at the National Institute of Health, there are mechanical and biochemical effects.  It is essential to elicit the so-called local twitch responses, which are spinal cord reflexes. Getting local twitch responses with trigger point dry needling is the first step in breaking the pain cycle.

Is trigger point dry needling similar to acupuncture?

There are many similarities and differences between trigger point dry needling and acupuncture, however, they are not the same.   Licensed physical therapists in a growing number of states can use trigger point dry needling under the scope of their practice.  The physical therapists at Synergy Health & Wellness are not licensed acupuncturists and do not practice acupuncture.  In contrast to most schools of acupuncture, trigger point dry needling is strictly based on Western medicine principles and research.

What type of problems can be treated with trigger point dry needling?

Trigger point dry needling can be used for a variety of musculoskeletal problems. Muscles are thought to be a primary contributing factor to the symptoms. Such conditions include, but are not limited to neck, back, and shoulder pain, arm pain (tennis elbow, carpal tunnel, golfer’s elbow), headache to include migraines and tension-type headaches, jaw pain, buttock pain and leg pain (sciatica, hamstring strains, calf tightness/spasms). The treatment of muscles has the greatest effect on reducing the pain mechanisms in the nervous system.

Is the trigger point dry needling procedure painful?

Most patients do not feel the insertion of the needle. The local twitch response elicits a very brief (less than a second) painful response. Some patients describe this as a little electric shock; others feel it more like a cramping sensation. Again, the therapeutic response occurs with the elicitation of local twitch responses and that is a good and desirable reaction.

Are the needles sterile?

Yes, Synergy Health & Wellness only uses sterile needles. Physical therapists wear gloves and appropriate personal protective equipment (PPE) when dry needling, consistent with Standard Precautions, Guide to Infection Prevention for Outpatient Settings, and OSHA standards. The sterile needles are disposed of in a medical sharps collector.  

What side effects can I expect after the treatment?

Most patients report being sore after the procedure. The soreness is described as muscle soreness over the area treated and into the areas of referred symptoms. Typically, the soreness lasts between a few hours and two days.

What should I do after having the procedure done?

Our recommendations vary depending on the amount of soreness you have and on the individual response to the treatment. Recommendations may include applying heat or ice over the area, gentle stretches and modifications of activities.

How long does it take for the procedure to work?

Typically, it takes several visits for a positive reaction to take place. We are trying to cause mechanical and biochemical changes without any pharmacological means. Therefore, we are looking for a cumulative response to achieve a certain threshold after which the pain cycle is disturbed.

Why is my doctor not familiar with trigger point dry needling?

In the US, trigger point dry needling is a relatively new method for treating myofascial pain and not everyone is already aware of this effective modality. Feel free to inform your doctor about this treatment option. It is upon all of us to educate others about new and innovative ways to treat pain 

Where does trigger point dry needling fit into the entire rehabilitation program?

Generally speaking, trigger point dry needling is the modality of choice when it comes to treating patients in the clinic. More frequently, trigger point dry needling is needed in the beginning in order to break the pain cycle. Once that is achieved, other treatment options are introduced.

Once I am feeling better, how often to do I need to come back to maintain my progress?

The musculoskeletal system is under constant pressure from gravity, stress, work, etc. A regular exercise program combined with good posture can prevent many problems. If the pain comes back, “tune-ups” are recommended to treat and prevent serious injuries.

Where can I find more information about Trigger Point Dry Needling?

Visit http://www.painpoints.com/patients/resources_articles.html to get more information about the procedure and the people that are licensed to perform it.

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