Dry needling is a relatively new and excellent technique for treating myofascial pain syndrome, carried out by trained physiotherapists and doctors. As part of manual therapy, it is a treatment of choice for resolving problems with painful muscular trigger points, eliminating pain-causing substances and breaking the pain cycle.
Superficial and, in particular, deep dry needling are special techniques that offer greater effectiveness and reach parts of the body where conservative treatment is unable to improve the clinical picture. It can be performed on almost all muscles while respecting the anatomy and safety precautions. Myofascial painful trigger points (TrP) are located by palpation, after which an acupuncture needle is applied to the trigger point. The effect is a reduction of pain in the area of the trigger point and in the distant zones to which the pain radiates, together with increased mobility.
Each patient is approached individually and the application technique is adapted to their particular problem. It can be a standalone procedure or combined with other physiotherapy procedures. 3–6 treatments at weekly intervals are recommended. The therapy may only be carried out by specially trained physiotherapists.
Trigger points are irritable, hard „knots” in the muscle that respond to pressure, sending pain into the surrounding tissue and making everyday activities difficult.
Most common applications by area
- Lumbopelvic area: m. longissimus dorsi, m. gluteus maximus, m. gluteus medius
- Lower limb: m. tensor fasciae latae, m. adductor longus, m. rectus femoris, m. vastus lateralis, m. vastus medialis, m. biceps femoris, m. semitendinosus, m. semimembranosus, m. tibialis anterior, mm. peroneus longus et brevis, mm. gastrocnemius medialis et lateralis, m. abductor hallucis longus
- Neck: m. trapezius pars descendens, m. levator scapulae
- Suboccipital area, mandible and head: the attachment of the m. trapezius pars descendens, m. masseter, m. temporalis
- Upper limb: m. infraspinatus, m. latissimus dorsi, m. deltoideus, m. triceps brachii, m. biceps brachii, the wrist extensors and flexors, m. adductor pollicis brevis
Among the first generation of physiotherapists who, in May 2015, completed the first certified Dry needling and myofascial trigger point course in Serbia is Jovan Rogić, a professional physiotherapist and founder of the Rehability Clinic. The course was organised by the INSTEMA Institute of Manual Therapy from Spain, with lecturer Dr Cesar Calvo.