Dry Needling

Dry needling is a relatively new therapy that has been part of physiotherapy in the Netherlands since 2007. Treatment focuses specifically on complaints where muscles are tense – often for a long time – and causing pain. Examples include headache, neck and shoulder pain, lower back complaints, tennis elbow and golfer's elbow, among others.

It is now a widely used technique for releasing muscle tightness, so-called “myofascial trigger points”, by inserting a thin acupuncture needle into them.

Myofascial trigger points feel like a hard spot (a “knot”) in a muscle that, besides local tenderness, can also cause pain elsewhere in the body. The therapist can genuinely feel the tightness, and the patient feels that it is painful to the touch. These trigger points cause muscles to move less freely, which in turn reduces blood flow and can lead to shortening (cramping) of the muscle.

Releasing active trigger points works as follows. A thin acupuncture needle is inserted precisely into the trigger point. You will feel little or nothing as the needle goes in. The aim is to trigger a reflex known as a “local twitch response”. This reflex is comparable to the well-known knee-jerk reflex, where a tap on the knee briefly tenses the entire thigh muscle. With dry needling, however, you can very specifically target just the muscle fibres where the trigger point is located. As a result, the muscle – which has been held in a tensed position for a long time – is briefly tensed even further, producing a kind of reset of those muscle fibres, after which the muscle relaxes again. This happens so quickly that it can give you a brief start, and in some cases it may feel somewhat painful. The muscle becomes more supple, mobility increases, and the pain can already lessen immediately. After treatment you may experience a sensation similar to muscle soreness, which can last a day or two. After that, the whole muscle will feel noticeably more relaxed.

If complaints have been present for longer, more muscles are usually involved. Complaints often spread, including along the spine. I include these muscles in the treatment as well. It is therefore very important that the initial assessment looks at muscle chains, among other things, rather than focusing on just one muscle. Where necessary, the skin and periosteum can also be treated with specific dry needling techniques to achieve greater effect. Because I have also completed additional dry needling courses, virtually any muscle causing complaints – back, neck, limbs, head, jaw, throat – can be treated.

Dry needling is never a stand-alone therapy and is always supported with specific exercises or advice, to prevent the trigger points from returning just as stubbornly as before. I usually combine several treatment approaches here, and exercises from McKenzie therapy often come in useful.