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Dry needling, also known as trigger point dry needling and intramuscular stimulation, is a treatment technique used by various healthcare practitioners, including physical therapists, physicians, and chiropractors, among others. Acupuncturists usually maintain that dry needling is adapted from acupuncture, but others consider dry needling as a variation of trigger point injections. It involves the use of either solid filiform needles or hollow-core hypodermic needles for therapy of muscle pain, including pain related to myofascial pain syndrome. Dry needling is mainly used to treat myofascial trigger points, but it is also used to target connective tissue, neural ailments, and muscular ailments. The American Physical Therapy Association defines dry needling as a technique used to treat dysfunction of skeletal muscle and connective tissue, minimize pain, and improve or regulate structural or functional damage. There is conflicting evidence regarding the effectiveness of dry needling. Some results suggest that it is an effective treatment for certain kinds of muscle pain, while other studies have shown no benefit compared to a placebo; however, not enough high-quality, long-term, and large-scale studies have been done on the technique to draw clear conclusions about its efficacy. Currently, dry needling is being practiced in the United States, Canada, Europe, Australia, and other parts of the world. Origin Etymology and terminology The origin of the term dry needling is attributed to Janet G. Travell. In her 1983 book, Myofascial Pain and Dysfunction: Trigger Point Manual, Travell uses the term dry needling to differentiate between two hypodermic needle techniques when performing trigger point therapy. However, Travell did not elaborate on the details on the techniques of dry needling; the current techniques of dry needling were based on the traditional and western medical acupuncture. Initial techniques The two techniques Travell described are the injection of a local anesthetic and the mechanical use of a hypodermic needle without injecting a solution. Travell preferred a, 1.5-in hypodermic needle for trigger point therapy and used this needle for both injection therapy and dry needling. Travell never used an acupuncture needle. Travell had access to acupuncture needles but reasoned that they were far too thin for trigger point therapy. She preferred hypodermic needles because of their strength and tactile feedback: "A 22-gauge, 3.8-cm (1.5-in) needle is usually suitable for most superficial muscles. In hyperalgesic patients, a 25-gauge, 3.8-cm (1.5-in) needle may cause less discomfort, but will not provide the clear feeling of the structures being penetrated by the needle and is more likely to be deflected by the dense contraction knots that are the target... A 27-gauge needle, 3.8-cm (1.5-in) needle is even more flexible; the tip is more likely to be deflected by the contraction knots and it provides less tactile feedback for precision injection". Development and regulation in the United States The solid filiform needle used in dry needling is regulated by the FDA as a Class II medical device described in the code titled "Sec. 880.5580 Acupuncture needle is a device intended to pierce the skin in the practice of acupuncture". Per the Food and Drug Act of 1906 and the subsequent amendments to said act, the FDA definition applies to how the needles can be marketed and does not mean that acupuncture is the only medical procedure where these needles can be used. Dry needling using such a needle contrasts with the use of a hollow hypodermic needle to inject substances such as saline solution, botox or corticosteroids to the same point. The founder of Integrative Systemic Dry Needling (ISDN), Yun-Tao Ma, has been spearheading the "dry needling" movement in the United States. Ma states, "Although ISDN originated in traditional Chinese methods, it has developed from the ancient empirical approach to become modern medical art rooted in evidence-based thinking and practice." Ma also states that, "Dry needling technique is a modern Western medical modality that is not related to traditional Chinese acupuncture in any way. Dry needling has its own theoretical concepts, terminology, needling technique and clinical application." The American Academy of Orthopedic Manual Physical Therapists states:Dry needling is a neurophysiological evidence-based treatment technique that requires effective manual assessment of the neuromuscular system. Physical therapists are well trained to utilize dry needling in conjunction with manual physical therapy interventions. Research supports that dry needling improves pain control, reduces muscle tension, normalizes biochemical and electrical dysfunction of motor end plates, and facilitates an accelerated return to active rehabilitation.Dry needling for the treatment of myofascial (muscular) trigger points is based on theories similar, but not exclusive, to traditional acupuncture; both acupuncture and dry needling target the trigger points, which is a direct and palpable source of patient pain. A high degree of correspondence is reported between myofascial trigger point dry needling and traditional western acupuncture. Acupuncture and dry needling are similar in the underlying phenomenon and neural processes between trigger points and acupuncture points. There is a high degree of correspondence between published locations of trigger points and classical acupuncture points for the relief of pain. Dry needling, and its treatment techniques and desired effects, would be most directly comparable to the use of 'a-shi' points in acupuncture. However, dry needling theory only begins to describe the complex sensation referral patterns that have been documented as "channels" or "meridians" in Chinese Medicine. What further distinguishes dry needling from traditional acupuncture is that it does not use the full range of traditional theories of Chinese Medicine which is used to treat not only pain, but also other non-musculoskeletal issues that often cause pain. The distinction between trigger points and acupuncture points for the relief of pain is blurred. Technique Technique for dry needling depends on which tissue is being targeted and what the overall objective of the treatment is. For example, one of the most common treatment objectives for dry needling, myofascial trigger points (TrPs), differs physiologically from treatments for scar tissue, connective tissue issues, and other medical issues. In the treatment of trigger points for persons with myofascial pain syndrome, dry needling is an invasive procedure in which a filiform needle is inserted into the skin and muscle directly at a myofascial trigger point. A myofascial trigger point consists of multiple, hyperirritable contraction knots related to the production and maintenance of the pain cycle; essentially, myofascial trigger points will generate much local pain upon stimulation or irritatio.... Discover the Karel Lewit popular books. Find the top 100 most popular Karel Lewit books.