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Dry Needling in Denver: What is Trigger Point Dry Needling, also known as TPDN, TDN, or IMS (Intra Muscle Stimulation)?


February 14, 2018

Have you ever wondered what those nasty little knots are that appear in your muscles and cause you pain?  They may be active trigger points in your muscle or connective tissue. Physical therapist that are trained in treatment of trigger points through trigger point dry needling. Trigger point dry needling can treat these points to provide relief of even chronic pain symptoms. The term ‘dry needling’ was coined to differentiate it from ‘injection needling’ where a substance (medication or otherwise) is injected into tissue with a hypodermic syringe.

Trigger points occur when there is too much electricity trapped in the muscle fibers.  This can happen through injury, misuse or overuse of a muscle. Trigger point dry needling is a technique where acupuncture needles are inserted into a myofascial trigger point, muscles or connective tissues to help release trapped electricity and, essentially, deflate the trigger to relieve pain.  It is known that the use of trigger point dry needling activates a ‘local trigger response’, an involuntary spinal cord reflex, although some of its biochemical and neurophysiological effects are still being studied.

While trigger point dry needling utilizes the same solid filiform needles, typically .16-.31 mm in thickness, that the Traditional Chinese Medicine of acupuncture utilizes, its science and research is based off western medicine principles and large body of research of the human muscular system.  The effects and mechanisms of dry needling are complex though research suggests that the local twitch response elicits a response from the brain in the area of pain or discomfort. There is a growing body of scientific evidence that supports the positive effect inserting a needle has on the electrical and chemical communications that take place in our nervous system, including the natural release pain relieving chemicals as well as the transmission of pain signals in our spinal cord. 

Trigger point dry needling can also be utilized as a diagnostic tool for physical therapists as the local twitch response would not be stimulated within healthy muscle tissue.  Trigger point dry needling may be heavily utilized near the beginning of a treatment plan as a means to break the cycle of pain.  After the technique is applied to a particular area, the muscle then needs to undergo re-education through exercise to help it learn how to work normally again.  This will help reduce recurrence of these trigger points, and help provide long term relief from pain.

Why does trigger point needling work?

The most widely accepted theory as to the reason trigger point dry needling works to help treat muscle spasms and reduce further muscle damage is that a muscle spasm creates a cycle of pain which further inhibits blood flow, oxygen and nutrients to the muscle tissue.  By introducing a needle and disrupting this cycle, the muscle is allowed to relax and repair itself while allowing further treatment using standard physical therapy practices.

This is a technique that should only be performed by someone who has been trained, and your physical therapist may be that person.  Physical therapists will typically utilize trigger point dry needling as a single tool within its larger treatment plan for any given condition.  Release of trigger points may provide relief from pain that has been present for short or long periods of time.  Some patients may feel soreness immediately following and even a few days after in the area of treatment and some may even see signs of bruising.  Most of the symptoms of trigger point dry needling are mild and will only last a few days, depending on the patient and in comparison to the pain usually experienced caused by the condition, the pain will be much less.

What can be treated by trigger point dry needling?

Trigger point dry needling can help with a variety of common conditions including headaches, shoulder pain, neck pain, back pain, knee pain, sciatica, Achilles tendonitis, plantar fasciitis, tennis elbow, golfers elbow, hip pain, gluteal pain, muscle strains, ligament strains, muscle spasms, jaw pain, sore muscles, tight muscles and more.

How is trigger point dry needling different from acupuncture?

As mentioned above there are some similarities between the Ancient Chinese Medicine of acupuncture and trigger point dry needling including the disposable, sterile needles used in each, however acupuncture largely is used as a method to treat ailments internally such as stress, insomnia and digestive problems.

With a session of acupuncture the needles inserted into a patient are done so along meridian lines and often left in for around 30 minutes.  The meridians lines represent the body’s organ systems.  By inserting needles along the meridian lines, acupuncturists attempt to rebalance and restore energy flow throughout the body.

In comparison, trigger point dry needling can oftentimes be finished in a few minutes depending on the condition, size of area and complexity of the problem.

Example of trigger point dry needling successes

Recent patient experiences include individuals suffering from muscles spasms in a patient’s back caused from a strain in one of the major shoulder muscle groups.  The strain of this muscle cause the body to use muscles which were much weaker causing them to contract beyond a point of function.  In order to restore function to the area, trigger point dry needling was done to these muscles.  Once the patient had relief from the pain, additional strengthening therapy was prescribed in order to teach the muscles how to properly function.

Who licenses and regulates dry needling in Colorado?

In Colorado, the Department of Regulatory Agencies and State Physical Therapy Board has regulated the use of trigger point dry needling in 4 CCR 732-1.  In the United States, Medical Doctors, Osteopaths, Physical Therapists, Chiropractors, Naturopaths and Acupuncturists are utilizing Dry Needling.

If stretching, massage, or just plain ignoring the pain has not worked for you, consider trying trigger point dry needling. Consult Body Image Physical Therapy to understand and discuss if trigger point dry needling may be a good option for you and your condition.