TDN is the acronym used for Trigger Point Dry Needling, also referred to as Myofascial Trigger Point Dry Needling. It is an effective therapy used to treat both specific muscle spasms and muscular tension in general – irrespective of the origin of the pain. It is termed ‘dry needling’ because unlike needles used for injections a different type of needle is usually used – though a hollow-core hypodermic needle may also be used. TDN however primarily uses a thin, small, solid filament/filiform needle, also referred to as an ‘acupuncture’ needle, which results in a mechanical effect known as a localised twitch reflex/response [LTR] to bring about treatment effect. Unlike Chinese acupuncture, which uses specific energetic points for needling, in TDN treatment the needle is inserted into musculoskeletal trigger points to bring about pain relief. It is called ‘dry needling’ because no solution is injected into the tissues to relieve pain, instead the pain-relief response is due to the needle itself and the specific effect it has on the body tissue/area being treated.
What TDN is not.
TDN is not Acupuncture or Biopuncture. TDN is a separate and distinct methodology and practice that is based on Western medical research and principles. Acupuncture is based on Traditional Chinese Medicine [TCM] philosophy, principles and practise. The primary similarity is the use of the same disposable, solid filament needles. Biopuncture is a distinct therapy in its own right that uses a hypodermic needle to inject specific body areas, like muscles and skin, with various low-dose natural and biological products.
Does it hurt?
Yes and no. Some people feel the insertion of the needle, others not. The technique may include tweaking the needle gently to produce the requisite twitch response. This can produce a quick [1-second] pain or ache sensation – but it’s over in a flash and is considered a necessary part of the therapeutic process.
Why and how does it work?
The LTR initiates the break in the pain cycle via three major dry needling action pathways: mechanical, neurophysiological and chemical. These effects result in decreasing pain and muscle contraction, improving flexibility, and reducing chemical irritation in tissues. An added bonus is that the muscle fibres respond to needle penetration via both a local and a systemic anti-inflammatory response.
Pain & Pain Relief
Injury to body tissue invariably results in inflammation, and especially in skeletal muscle the injured tissue and muscle fibres contract to prevent further tissue damage, which is experienced as muscle spasm. Unfortunately the result of this naturally protective tissue response is pain, since inflammation and contracture both inhibit microcirculation. Whenever the microcirculation is impaired the injured tissue site becomes hypoxic or oxygen-poor, as well as less effective at disposing of metabolic waste products that result from injury. To further protect the tissues after injury, the body produces fibrotic and scar-tissue forming cells called fibroblasts, often accompanied by nerve compression or irritation that may aggravate or limit biomechanical and tissue function. Relative to a neurophysiological effect, according to research by Peter Baldry, it has been shown that dry needling techniques stimulate Group 111 A-nerve fibres for up to 72 hours after treatment, helping to reduce pain via opioid-mediated suppression. Pain relief has also been demonstrated in studies that have shown increased levels of a range of chemicals at sensitised motor endplates – findings that are particularly relevant to managing myofascial pain.
Conditions that may benefit from TDN
Some of the many and varied conditions that cause muscular pain and spasm include neck, back, hip, gluteal, knee and shoulder pain, sciatica, tendonitis, plantar fasciitis, tennis elbow, headaches, nerve irritation, repetitive strain injuries, carpal tunnel syndrome, muscular and ligament strain, pain from sport or other traumatic musculoskeletal injury, arthritis, chronic pain, and myofascial pain syndrome.
