The medical journal to be summarized is Jan Dommerholt’s Dry Needling in Orthopaedic Physical Therapy Practice. Dommerholt introduces dry needling as a technique used by physical therapists to treat myofascial pain in which a dry needle is inserted into a trigger point to inactivate it and relieve pain…
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Then, he describes three basic dry needling models namely Myofascial Trigger Point Model (where he states how dry needling is used for the treatment of myofascial trigger points (MTrPs)), Radiculopathy Model (that is, the myofascial pain syndrome (MPS) is caused by peripheral neuropathy or radiculopathy and the innervated structures function correctly if there is a free flow of nerve impulses, otherwise these innervated structures become supersensitive), and The Spinal Segmental Sensitization Model (in which Dommerholt describes two approaches presented by Gunn and Fischer). He states that the Spinal Segmental Sensitization Model has been developed by Dr. Andrew Fischer, and combines features of Travell and Simons’ trigger point model and Gunn’s radiculopathy model. According to them, the musculoskeletal pain can be relieved by certain methods such as needling of trigger points, somatic and preinjection blocks, spray and stretch, and exercises for the relaxation of the targeted muscles. The main difference between the two approaches put forth by Gunn and Fischer is that Fischer uses injection needles whereas Gunn uses acupuncture needles.
Then, Dommerholt talks about mechanical, neurophysiological and chemical effects of dry needling. He states that when an MTrP is triggered in dry needling, it mechanically interrupts with the dysfunctional motor end plates. If an MTrP is mechanically stretched by the needle, then by rotating it, the connective tissue gets wrapped around it, referred to as ‘needle grasp’. The therapist can cause the needle grasp to occur by moving the needle up and down when he is inserting it in an MTrP. It causes the change in total length of the fiber and blocks the nociceptive substances, which relieves pain eventually. Talking about neurophysiological effects, Dommerholt mentions Baldry who says that the superficial dry needling causes prolonged stimulation of A-delta nerve fibers which suppresses the pain.
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