Trigger Point Dry Needling
Acupuncture Physical Medicine (APM), also known as Trigger Point Dry Needling, was developed by my school's headmaster, Mark Seem, and based on Janet Travell's books on trigger points. This technique releases tension and knots in muscles to alleviate musculoskeletal pain and even internal visceral symptoms (such as chest pain or digestive disorders) without the injections of steroids or numbing agents.
As we all know, our muscles will contract and release to create movement. When a muscle tightens, forms a knot, or goes into spasm, that cycle of contracting and releasing is interrupted, and the muscle gets "stuck" in a semi-contracted state, unable to release. Trigger point dry needling uses the acupuncture needle to force the muscle to fully contract which then allows it to fully release.
What to Expect
The action of Trigger Point Dry Needling creates a twitch response which can feel very strange to the patient and even re-create some of the symptoms you feel from the area. These sensations are normal but can feel intense, so it's very important that you communicate what you're feeling to me. We can take a break or change up the needling technique to make the experience more comfortable.
After a treatment, patients will feel soreness that typically lasts for 1-2 days. Make sure you're drinking plenty of water and apply heat to the area in 15 minute intervals. You can also apply any liniments you have at home such as IcyHot, Bengay, or Tiger Balm. It is of extreme importance that you DO NOT apply ice to the area because the ice will tighten the muscle again. If it feels inflamed or if applying heat is bothersome, use a cooling liniment such as White Flower Oil, BioFreeze, or Mineral Ice.
It's also normal to feel some improvement but then feel the pain begin to return. Acupuncture (and especially APM) has a cumulative effect. As you continue through your treatments, you'll find the relief lasts longer and longer until eventually, you won't need treatments any longer.
Dry Needling: That Means Acupuncture
In some states, it's legal for Physical Therapists to practice dry needling. This is not only considered to be unethical (the way in which acupuncture is legally defined would include dry needling as a practice of acupuncture), but it can also be dangerous. To dry needle without proper training can lead to further spasming, nerve damage, severe bruising, or punctured organs. Some PT's are able to practice dry needling after taking a brief course. A licensed acupuncturist has spent 3,000 hours memorizing safe needle depths, and practicing how to properly angle a needle to reach a muscle without causing damage to any of the deeper viscera, surrounding vascular structures or nerves, before being required to pass national and state board exams. We also learn several different needling techniques so that we can make the experience less intense for our patients.
The End of an Ice Age
After your treatment, I always recommend heat. For anyone who has undergone my treatment, you know how passionate I am about avoiding the use of ice. There are two good reasons for this: one, inflammation is your body's natural response to fight infection, so why would we want to prevent that? Two, ice is for dead things and if you're reading this, odds are you're not dead. The way that ice is stops inflammation is the same way it prevents decomposition: by stopping blood flow. No blood flow means no nutrients to the injured area and that means you can't properly heal, and any junk from the inflammatory response is now just stuck in the area. No blood flow also means stagnation, and in Chinese medical theories, stagnation creates pain. Don't believe me? Maybe Dr. Mirkin (the man who coined the RICE acronym) can convince you.