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Dry Needling
WHAT IS DRY NEEDLING?
Dry Needling, simply put, is rebooting the mechanism. A very tiny needle (.25-.30 mm in diameter) is placed in a nerve ending (homeostatic point) or a "Knot" (trigger point) with the goal of resetting the tissue to its normal function,(homeostasis). An analogy for the homeowner would be rekindling the pilot light on your furnace. You push the little red reset button, the pilot light is activated and the water heater returns to its normal function of heating water.
People ask "Is Dry Needling painful"? If the initial piercing of the skin is done correctly you may not feel more than pressure. Some hypersensitive skin may feel the prick, some won't. Then, the next sensation you feel is of the hypertonic muscle or tissue fully contracting when the needle reaches it. The contraction, according to those who have received this treatment, "is not what you had expected". The results are truly amazing.
WHAT IS THE HISTORY OF DRY NEEDLING?
In the 1940s, Dr. Janet Travell identified that muscular pain typically contained a point within the muscle that triggered the muscle to become hypertonic and painful. She found that these “Trigger Points" could be reduced or abated by injecting Novacaine or Botox (or botulinum toxin A) into the region. This same research, which identified the efficacy of this “wet needling", also discovered that inserting a "dry needle" into the symptomatic tissue offered the same results. This was groundbreaking work and hence she created the term "Dry Needling". She and Dr. David G. Simon carefully identified most of the trigger points located in the human body.
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Jan Dommerholt DPT began working alongside Dr. Travell and her partner, Dr. David Simons in developing a safe and effective release of symptomatic tissue. In 1997 Jan began teaching Dry Needling techniques and continues to champion evidence-based Dry Needling Techniques all over the globe.
DR. JAN DOMMERHOLT
www.myopainseminars.com
In the late 1970’s Dr. C. Gunn developed the concept and technique of Intramuscular Stimulation (IMS). IMS is a technique for the treatment of myofascial pain syndrome based on a comprehensive diagnostic and therapeutic model that identifies the etiology of myofascial pain as neuropathic i.e. due to disease or dysfunction in the nervous system. It specifically identifies the nerve root as the generator of the pathology, so it is referred to as a radicular-neuropathic model.
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In the late 1970s, Dr. H.C. Dung, a professor of anatomy, in San Antonio, Texas, discovered the homeostatic points. Dr. Janet Travell recognized and was impressed by Dr. Dung’s discovery (personal communication). In 1999, Dr. H.C. Dung and Dr. Yun-Tao Ma co-authored the book "Scientific Acupuncture for Healthcare Professionals" published in China. This was the first modern needling textbook published in China. Later they co-authored the second book, "Pain Measurement of the Human Body" also published in China to further explain the clinical application of the system.
Dr. Yun-Tao Ma's experience with needling dates back to 1968 in China where he was interested in pain science. This led to Dr. Ma being trained as a Neuroscientist at the National Institute of Health (NIH) and as a pain researcher in the Department of Physical Therapy at the University of Iowa. Dr. Ma continued Dr. Dung’s work to explore the physiology of the homeostatic point system and their clinical application where discovered a relationship between homeostatic points and human biomechanical homeostasis. He also found that all modern dry needling modalities with seemingly different theories and clinical techniques, in fact, share the same physiology and are not in conflict with each other. (The Law of Dry Needling).
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(The above history was adapted from an article written by Frank Gargano. https://integrativedryneedling.com/history-of-dry-needling/
Glenn Flaming PT, MPT took his first Dry Needling course directly from Jan Dommerholt at Myopain Seminars in 2016. That was one year after the Maine State Legislature first allowed physical therapists to incorporate this valuable modality into their already vast tool bag towards treating myofascial pain. In his 20+ years of physical therapy practice, he knew it was a natural fit to add this modality into his healing approach. In 2018, Glenn then expanded his expertise in Dry Needling to include treating Homeostatic Points; studying with the Integrative Dry Needling School which was founded by Dr. Yun-Tao Ma.
DR. YUN-TAO MA
www.integrativeneedling.com
IS DRY NEEDLING THAT SAME THING AS ACUPUNCTURE?
The conversation must start with a respectful acknowledgment that both Acupuncture and Dry Needling are modalities that accompany many years of post-graduate study. Acupuncturists study 3-3.5 years of Traditional Chinese medicine. Physical Therapists also spend 3-4 years in post-graduate degrees, with extensive expertise in the anatomical study and understanding of movement dysfunction.
The Acupuncturist spends a lifetime studying the Qi, energy flow, and the Chinese Meridians. They are experts in Traditional Chinese Medicine. As part of that expertise, they incorporate Acupuncture, a multifaceted approach attempting to normalize the Qi. Traditional Acupuncture treats patients along the theoretical energy pathways called Meridians. It does not purposefully target any particular anatomical structure.
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Orthopedic Physical Therapists are experts in the musculoskeletal system which is heavily based on anatomical form and function. It relies on Kinesiology (the study of movement), to establish normal and repeatable movement patterns in the body. When an aberrant or painful movement pattern is discovered, the PT tries to systematically treat the “disease state” through the best practice and evidence-based protocols of treatment. As seen above, the treatment of Trigger Point pain and tension is well-grounded in the education and Professional Practice Act of all Physical Therapists. Therefore, when Dr. Dommerholt began teaching Physical Therapists how to Dry Needle, he was merely introducing a new modality to highly educated medical practitioners.
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Now that this modality has become a staple within our practice paradigm, we have treated many patients who have also been treated by highly skilled Acupuncturists. The average patient sees the mode of treatment and will often equate Dry Needling with Acupuncture. But, after receiving their first treatment in this modality most patients state that Dry Needling is completely different from any Acupuncture they had ever received. We have come to see, anecdotally, that these two distinct treatment strategies are not the same at all. We believe that our local medical community in Midcoast Maine will discover how our practices complement each other. In the coming years, we will work together towards a common goal instead of attempting to eradicate one treatment strategy over the other.
IS DRY NEEDLING COVERED BY INSURANCE?
Most major medical plans do not pay the Provider for utilizing this as a separate modality. Therefore, if your Physical Therapist sees this form of treatment as a benefit to the patient, you will be informed prior to incorporating this modality into your treatment. After giving informed consent, you will be asked for payment on the day of treatment and your insurance will not be billed.