Physiologic Effects of Dry Needling

Cagnie, Barbara; Dewitte, Vincent; Barbe, Tom; Timmermans, Frank; Delrue, Nicolas; Meeus, Mira

doi:10.1007/s11916-013-0348-5

Cited by 243 publications

(208 citation statements)

References 54 publications

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“…Spinally, DN needling has been shown to activate the descending pain modulatory system, which is mediated by a synergic relationship between opioids and non-opioids, including serotonin and norepinephrine [185]. Guo et al found that EDN results in the reciprocal stimulation of β-endorphin containing neurons in the arcuate nucleus (ARC) and periaqueductal grey (PAG) via glutamate transporter-3 [186].…”

Section: The Role Of Spinal Opioids/non-opioids In Dry Needling Mediamentioning

confidence: 99%

Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals

Butts¹,

Dunning²

2016

Int J Phys Med Rehabil

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There are a number of biochemical, biomechanical, endocrinological and neurovascular mechanisms underpinning the anti-nociceptive and anti-inflammatory effects of dry needling (DN). While myofascial trigger points likely play a role in peripheral pain, a diagnostic tool for localizing them has not been validated, and DN studies that have targeted trigger points to elicit localized twitch responses have reported mixed results. Therefore, the mechanism responsible for DN-mediated analgesia may be more complicated. DN activates opioid-based pain reduction, mediated by endogenous cannabinoids and the sympathetic nervous system, and non-opioid pain relief via serotonin and norepinephrine from the brain stem. DN also triggers the hypothalamic-pituitary-adrenal axis centrally and the corticotropin releasing hormone-proopiomelanocortin-corticosteroid axis locally to inhibit cox-2, reducing inflammatory cytokines. Recent studies demonstrate that DN combined with mechanical and/or electrical stimulation may reverse PKC-mediated peripheral hyperalgesic priming by normalizing nociceptive channels, to include TRPV, ASIC, TTX and P2X/Y. Electrical DN (EDN) stimulates immune cells, fibroblasts and keratinocytes to release CGRP and substance-P, altering the stimulation of TTX receptors to reverse hyperalgesia. It also encourages the supraoptic nucleus to release oxytocin to quiet ASIC receptors peripherally and stimulate opioid interneurons spinally. Moreover, EDN inhibits ERK1/2 kinase pathways of inflammation in the spinal cord and stimulates Aδ fibers and N/OFQ to reverse C-fiber mediated central changes. Mechanotransduction of fibroblasts and peripheral nerves via TRPV1 and P2X/Y-mediated intracellular Ca 2+ wave propagation and subsequent activation of the nucleus accumbens inhibits spinal pain transmission via glycinergic and opioidergic interneurons. The increased ATP is metabolized to adenosine, which activates P1 purinergic receptors, events considered key to DN analgesia and rho kinase-based tissue remodeling. Mechanotransduction-mediated release of histamine further explains analgesia secondary to needling points distal to pain. DN-mediated analgesia is dependent on a number of synergistic physiologic events involving biochemical and mechanical processes in neural, connective and muscle tissue.

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Section: The Role Of Spinal Opioids/non-opioids In Dry Needling Mediamentioning

confidence: 99%

Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals

Butts¹,

Dunning²

2016

Int J Phys Med Rehabil

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“…These theories originate from the research performed by Simons and Travell, Gerwin, Shah, and Dommerholt. 10,[12][13][14][15][16][17] Based on the IMS theory, Gunn 18 proposes that the pain from MTrPs is a result of neuropathic pain from the irritation of the spinal nerve root caused by the shortening of the corresponding segmental paravertebral muscles. 13,18 Hypersensitivity then develops in skeletal muscles innervated with the nerve root, leading to the development of MTrPs.…”

Section: Introductionmentioning

confidence: 99%

“…8,[11][12][13]15,16,19,20 Individuals with and without low back pain have demonstrated varied responses in muscle activation following a dry needling intervention to the lumbar multifidi muscles. [21][22][23] Studies investigating the physiological effects of dry needling of the lumbar multifidi muscles in individuals with 22,23 and without low back pain 21 demonstrate changes in nociceptive sensitivity, segmental mobility and motor function following the interventions.…”

Section: Introductionmentioning

confidence: 99%

Spinal and Peripheral Dry Needling Versus Peripheral Dry Needling Alone Among Individuals With a History of Lateral Ankle Sprain: A Randomized Controlled Trial

Rossi

Blaustein

Brown

et al. 2017

Intl J Sports Phys Ther

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Background: In addition to established interventions, dry needling may reduce impairments leading to greater functional abilities for individuals following ankle sprain. Hypothesis/Purpose:The purpose of this study was to compare effects of spinal and peripheral dry needling (DN) with peripheral DN alone on impairments and functional performance among individuals with a history of lateral ankle sprain.Study Design: Randomized controlled trial. Methods:Twenty individuals with a history of lateral ankle sprain (18 bilateral, 2 unilateral) participated in this study (4 males, 16 females; mean age 28.9 +/-9.2 years). During the first of two sessions, participants completed the Foot and Ankle Disability Index (FADI) and the Cumberland Ankle Instability Tool (CAIT) and their strength, unilateral balance, and unilateral hop test performance was assessed. Participants were randomly assigned to a spinal and peripheral DN group (SPDN), or a peripheral only DN group (PDN). Participants in the SPDN site group received DN to bilateral L5 multifidi and fibularis longus and brevis muscles on the involved lower extremity. Participants in the PDN group received DN to the fibularis muscles alone. Participants' strength, balance and hop test performance were reassessed immediately following the intervention, and at follow-up 6-7 days later, all outcome measures were reassessed. Three-way mixed model ANOVAs and Mann-Whitney U tests assessed between group differences for outcome variables with normal distributions and non-normal distributions, respectively.Results: ANOVAs showed significant group by time interaction (p<0.05) for invertor strength, significant side by group and time by group interactions (p<0.05) for plantarflexor-evertor strength, no significant findings for dorsiflexor-invertor strength, significant side by time interaction (p<0.05) for unilateral balance, significant main effect of time (p<0.05) for triple hop for distance test, and significant main effect of side (p<0.05) for the CAIT. Mann-Whitney U tests showed no significance (p>0.05) for the side hop test or FADI. Conclusion:The results suggest that DN of the multifidi in addition to fibularis muscles does not result in improvements in strength, unilateral balance or unilateral hop test performance, compared to DN the fibularis muscles alone among individuals with a history of ankle sprain.

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“…There are several interventions currently adopted to treat trigger points [5] and dry needling is one of the most popular. It is a minimally invasive technique with documented benefits within the physiopathology of trigger points [6]. However, its use in the treatment of latent myofascial trigger points needs further investigation.…”

Section: Introductionmentioning

confidence: 99%

Using thermal imaging to monitor the treatment of latent myofascial trigger points in the upper trapezius

Seixas¹,

Soares²,

Vardasca³

et al. 2016

Proceedings of the 2016 International Conference on Quantitative InfraRed Thermography

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Clinically, latent myofascial trigger points are characterized as hyperirritable points located within taut bands of skeletal muscles or fascia. These points may cause referred pain, local tenderness and autonomic changes when manually stimulated. Dry needling is one of the treatment options but evidence of its results is scarce. This paper experimentally investigates the potential use of thermal imaging to assess the effect of dry needling on the skin temperature in patients with latent myofascial trigger points. No significant differences were found between the mean skin temperature and pain before and after the treatment, evidencing the agreement between the outcome measures.

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Physiologic Effects of Dry Needling

Cited by 243 publications

References 54 publications

Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals

Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals

Spinal and Peripheral Dry Needling Versus Peripheral Dry Needling Alone Among Individuals With a History of Lateral Ankle Sprain: A Randomized Controlled Trial

Using thermal imaging to monitor the treatment of latent myofascial trigger points in the upper trapezius

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