1What is dry needling
thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular, and connective tissues for the management of neruomusuloskeletal pain and movement impairments
2Methods of dry needling
superficial and deep
3Deep Dry needling
trigger points
paraspinal and peripheral nerves
tendons
4how does it work
abnormal _____ _______ ________ at the NMJ caused by excessive ____________ release
results in spontaneous _______ acitivity in NMJ
leads to sustained sarcomere __________
causes
end plate potential, acetylcholine
electrical
contraction
hyperalgesia, allodynia, and referred pain
5Effects
increased microcirculation
decreased spontaneous endplate activity
activation of descending pain inhibitory pathways
segmental inhibition/Gate theory
placebo!
6physiological effects
increase blood flow
decrease banding
decrease SEA
Biochemical changes
CNS Changes
TEMPORARY changes
7biochemical changes
decreased nociceptive sensitizing agents
increased endorphin levels of treated muscle
increased capillarity of tissue
sensory and proprioceptive stimulus
Change in neurotransmitters
sympathetic response
8contraindications
needle phobia
cognitive impairments
unwilling to be treated
unable to give consent
infection
lymphedema
hyperalgesia or allodynia
allergy to metal
abnormal bleeding
compromised immune system
pregnant
vascular disease
post op
9indications
pain
cramp
adhesion
scarring
tension related injury
trophic changes
contusion
inflammation
prevention