Fulcrum Clinic Services

The clinic provides a number of services to help you stay fit and healthy as well as the opportunity to relax and indulge yourself. 

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Dry Needling

You may have heard of a treatment called dry needling and wondered what exactly it is or if it’s something that may be right for you.

While the name of the procedure may sound intimidating, dry needling is safe, minimally discomforting and often an effective technique for patients with certain musculoskeletal presentations. Dry needling is a treatment performed by skilled, trained physical therapists, certified in the procedure. A thin monofilament needle penetrates the skin and treats underlying muscular trigger points for the management of neuromusculoskeletal pain and movement impairments.

 

So, what is a trigger point? A trigger point is a local contracture or tight band in a muscle fibre that can disrupt function, restrict range of motion, refer pain or cause local tenderness. When dry needling is applied to a dysfunctional muscle or trigger point, it can decrease banding or tightness, increase blood flow, and reduce local and referred pain.

 

It’s important to note dry needling is not the same as acupuncture. It uses similar tools, but that’s where the similarities end. Dry needling is performed by different practitioners with different training. Acupuncture is based on Eastern medicine, while dry needling is rooted in Western medicine and evaluation of pain patterns, posture, movement impairments, function and orthopaedic tests.

 

Dry needling treats muscle tissue, and its goal is to reduce pain, inactivate trigger points and restore function. It rarely is a standalone procedure. Rather, it often is part of a broader physical therapy approach incorporating other traditional physical therapy interventions into treatment.

Dry needling can be used for a wide variety of musculoskeletal issues, such as shoulder, neck, heel, hip and back pain. Research indicates dry needling is a safe and effective approach for treating and managing pain and can be used in conjunction with other treatments and so if you have any questions, please do not hesitate to contact the clinic.

 

How does dry needling work?

 

The exact mechanisms of dry needling are complex and not fully known. However, there is a growing body of scientific evidence that supports the positive effect inserting a needle has on the electrical and chemical communications that take place in our nervous system. These include inhibiting the transmission of pain signals in our spinal cord and increasing the release of our own pain-relieving chemicals within our brains.

 

Dry needling uses a very fine, solid filament needle to cause a small, precise injury or “lesion” in the tissue when it enters the body. The tiny needle induces injury signals the brain uses to initiate a sequence of events to replace or repair the damaged tissue with new, healthy tissue. Needling in a painful ‘trigger point’ or muscular knot frequently provokes a “twitch” response from the muscle. This is both diagnostic as well as therapeutic, because healthy muscle tissue will not “twitch” when stimulated by the needle. Once a “twitch” response has been elicited, the muscle fibers in that area relax, ‘inflammation’ is reduced and circulation improves. As a result of these physiologic processes, dry needling can purposely address muscle, tendon and myofascial pain and dysfunction.

 

Another theory is that the needle has an effect on one of the body connective tissue called Fascia. This tissue surrounds and protects the structures in the body including muscles, joints and nerves. Originally fascia was thought to be an innate substance with minimal neural input/output, but on-going research has found that fascia is a highly innervated tissue (lots of nerves), and therefore would have a strong response to a slightly invasive treatment technique – such as dry needling.

A lot of the literature focuses on ‘trigger points’, and dry needling’s effect on these, but unfortunately there is not really a general consensus on what a trigger point. Some well -established theories on the effect of needling trigger points include:

 

Theory A

 

1. Something causes pain, if it happens often enough or if the trauma is great enough, the pain signal may return and activate special pain receptors, which will feedback to the spinal cord. This will cause pain to continue instead of fade and is called a ‘Reflex Arc’.

 

2. At the same time motor neurones may become stuck in a feedback loop/reflex arc, facilitating muscle spasm. In some cases, the reflex arc continues for years, even decades.

 

3. Introducing a new stimulus (i.e. the needle) impedes the reflex arc and has the effect of relaxing the muscle.

 

Theory B

 

1. A muscle in constant spasm becomes a damaged muscle. Spasm reduces blood flow in the muscle. This means less oxygen and nutrients to the muscle. Muscle fibres die off and get replaced by fibrous scar tissue. This in turn holds the muscle tense, prevents muscle metabolites from leaving the muscle and causes continued spasm and pain.

 

2. Putting a needle into an active trigger point within the muscle causes the muscle to relax; this can be seen with an electromyogram (EMG).

If you require more information, please do not hesitate to contact the clinic.

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