Functional Dry Needling (FDN)

TDN Therapy/ IMS (Trigger Point Dry Needling) involves the insertion of monofilament needles into muscles in order to relieve pain and restricted range of motion.

TDN Therapy is NOT acupuncture. Acupuncture is based on restoring flow of energy (“chi”) along meridians in the body. In TDN, we have no intention of affecting these energy meridians. TDN is based on modern Western scientific principles and our knowledge of anatomy and physiology. We needle muscles that harbor trigger points.

A myofascial trigger point (TrP) is a tender “knot” in the muscle tissue. Most of us have these tender areas in various places in our bodies. You might feel a tight band of tissue for example in the upper trapezius muscle in your upper shoulder. In the middle of that tight band, you might feel a small hard nodule. That’s a trigger point. The nodule will be painful when you press on it. The trigger point may cause referred pain. That upper trapezius TrP may cause pain in your head and feel like a headache (picture below.) Often, the trigger point that causes symptoms might be quite distant from the painful area. For instance, the gluteus minimus muscle in the hip can cause pain all the way down the leg.

Myofascial trigger point (TrP) usually it happens when there is some kind of stress on the muscle. This may be from a sudden overload in a traumatic injury like a fall, a car accident or lifting something improperly. Or, it may happen over a long period of time for example from chronic postural stresses such as sitting at a computer. Most of us have movement patterns, which are not as efficient as they could be. We tend to overuse certain muscles, and underuse others. Also, TrPs can be caused or perpetuate by a problem with the nerves that supply the muscle. This often happens near the spine where the nerves exit from the spinal column. There may be a degenerated or herniated disc, or some arthritis in the joints of the spine. If the spinal nerves become compressed or irritated, the muscles that the nerves supply become more irritable and are likely to develop TrPs. Also, muscles at the spine are likely to tighten and develop TrPs, which will compress the nerve further.

This leads to a “vicious cycle” of pain and dysfunction. For this reason, we usually treat the of even for extremity pain. If you have pain in your shoulder, elbow or hand there may also be a problem in your neck. If you have hip, knee or foot pain you will usually benefit from treatment your low back.

There is ongoing research about what’s actually happening physiologically at a trigger point. We know that there is a continued release of certain neurotransmitters at the junction where the nerve and muscle meet. This causes a self-sustaining contraction in part of the muscle It holds on, and doesn’t usually let go until it is treated. Also, there is a low level of spontaneous electrical activity at the trigger point site. Because of the muscle tension, there may be some pressure and irritation on the nerve fibers and blood vessels in the area. This causes pain and tenderness in the area, and the decreased circulation causes an “energy crisis” at the trigger point.

Trigger point dry needling (TDN) is an advanced therapeutic technique that involves placing a small needle into a muscle in order to cause a quick contraction that releases the trigger point. This release improves flexibility and circulation in the muscle and can lead to a decrease in pain and other symptoms.

TDN can significantly improve range of motion in post surgical knees and shoulders, and is an effective treatment of low back pain and chronic conditions.

Trigger point dry needling is NOT acupuncture: it is not based on Eastern or Chinese medicine and diagnosis does not include evaluation of the meridians. It is based on Western medicine and muscle physiology, being orginally developed by a medical doctor.

Evolution Physical Therapy also utilizes a Real Time Ultrasound that provides pictures of structures below the skin. This gives our clinicians the ability see the depth of structures, and we believe this technology provides increased patient safety and efficacy and is included at no additional cost.