Dry Needling in Physical Therapy - Essay Example

Dry Needling in Physical Therapy 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 myofacial pain in which a dry needle is inserted into a trigger point to inactivate it and relieve pain. It is being taught in universities at Spain, Canada and Switzerland; but in United States, it is still controversial as to include it in physical therapy curricula or not.

According to him, MTrPs are defined as “hyperirritable spots in skeletal muscle associated with hypersensitive palpable nodules in a taut band” (p.15). 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 myofacial 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 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. Stimulation of A-delta also activates the serotonergic and noradrenergic descending inhibitory systems. Stimulation of A-delta also activates the serotonergic and noradrenergic descending inhibitory systems. The author mentions Shah and colleagues while mentioning chemical effects of dry needling, who state that the increased levels of certain chemicals, like bradykinin, CGRP, and substance P at MTrPs are at once corrected by drawing out LTR with the use of an acupuncture needle.

In the end, Dommerholt mentions statutory considerations in which states are considering whether to give dry needling the status of physical therapy or not. The author has expertly detailed dry needling while considering its status in physical therapy. ReferencesDommerholt, J. (2008). Dry needling in orthopaedic physical therapy practice. Orthopaedic practice, 16(3), pp. 15-20. Retrieved May 24, 2012, from http://www.kinetacore.com/physical-therapy/assets/files/level1-pre/Jan_Dommerholt_article_in_O.pdf