Staying consistent with your workouts is key to maintaining a body you’re proud of, but sometimes working out hard can cause pain and dysfunction that slows you down. Back pain in particular can be debilitating, since your back muscles are involved in almost every exercise you do. One common cause of exercise-related back pain is the presence of myofascial trigger points. Dry needling for back pain is a safe and effective procedure for eliminating trigger points that cause referred back pain.
What are Trigger Points and Where do They Come From?
The muscles throughout your body are encased in a network of thin tough sheathes of fibrous connective tissue called fascia. Fascia performs several important functions in your body:
– Holds bundles of muscle fibers together to keep them in place
– Separates individual muscles from one another so they can work independently
– Provides a pliable lubricated wrapper for muscles, nerves and blood vessels that helps them glide freely among and between organs, muscles, bones and connective tissue.
Without fascia, your muscles, nerves and blood vessels would be a soft mass of tissues that continually get in each other’s way! Just like muscles, fascia can succumb to overuse. Because fascia is frequently innervated by sensory nerve endings, overworked fascia can cause pain that is referred to muscles anywhere throughout your body. In response to overuse, fascial tissue sometimes contracts to protect itself, forming tiny spasms of taught tissue called myofascial trigger points.
How to Tell if Trigger Points are the Cause of Pain
Trigger points form taut nodules of tissue that can sometimes be detected by running your fingers over the skin’s surface. Active trigger points can be quite painful, but older trigger points may not be sensitive to the touch at all. Nevertheless, their presence can interfere with the smooth gliding of muscles, nerves and blood vessels. Sometimes trigger points form in tissues hidden deep within your body, where they cannot be detected by palpation. They often form near the myotendinous junction (MTJ) – the area where the muscle merges with tougher tendon tissue to exert force against a bone and produce movement. Because deep trigger points are hidden, it is almost impossible to determine if they are the underlying cause of pain without the assistance of deep tissue imaging.
What is Dry Needling for Back Pain?
Dry needling is an effective technique for getting rid of trigger points. The procedure involves inserting a thin dry (non-medicated) needle into the trigger point to invoke a twitch response. In effect, the needle reactivates the fascial tissue’s natural ability to contract and relax in response to nervous stimuli. Once stimulated by the needle, the tight knot of fascial tissue releases its contraction, relaxing the knot and alleviating pain. Superficial dry needling can easily be performed on trigger points that reside just below the skin’s surface and can be detected by palpation. But deep tissue dry needling presents a few problems:
1. The presence of a deep trigger point needs to be confirmed by imaging.
2. The inserted needle needs to precisely target the trigger point, which can be quite small.
3. Multiple blind insertions can be hit-or-miss, causing unnecessary pain and often failing to achieve the end goal of releasing the trigger point.
The Benefits of Ultrasound Imaging for Dry Needling Procedures
Detection and treatment of deep trigger points is greatly simplified by ultrasound imaging, the same type of imaging used to look at a growing fetus. It uses sound waves that bounce off internal surfaces at varying frequencies, creating gray-scale images that let us look below the surface to identify different types of structures. Ultrasound imaging offers many advantages:
– Unlike cumbersome MRI and Xray equipment, ultrasound equipment is compact and can easily be moved from place to place. It can even be carried onto a battlefield or playing field to assess combat or athletic injuries.
– Ultrasound imaging equipment is much less expensive than other imaging systems, making it convenient and affordable for private clinics and on-site medical services.
– Ultrasound lets us view the body’s structures in real time, for quick diagnosis – no waiting for hours or even days to get imaging results.
– Ultrasound lets us view the patient’s body in motion, with the patient as an active participant in their own diagnosis and treatment. Moving images allow us to see how the structures are moving and interacting in relation to one another, to detect impediments and dysfunction.
– Ultrasound lets us detect the exact location of trigger points embedded in deep tissues.
– Using ultrasound guidance during dry needling procedures, we are able to accurately and precisely target deep trigger points and eliminate them with a single insertion, greatly reducing pain and discomfort for the patient, and eliminating the need for multiple insertions at the same site.
Is Dry Needling an Effective Back Pain Treatment?
Back pain can arise from numerous causes, and many practitioners focus only on managing your pain symptoms without attempting to identify the full gamut of potential causes. You may be given narcotic pain pills, muscle relaxants, or steroid injections, and be told to take it easy. If pain persists, they may even recommend surgery. But in fit populations, surgery is rarely the remedy for back pain. If trigger points are the primary underlying cause of your back pain, dry needling can effectively eliminate it at the source. However, identifying the presence of trigger points does not guarantee that eliminating them will get rid of your back pain. An experienced practitioner with specific training and expertise in dry needling procedures will be able to accurately detect and precisely target trigger points with dry needling. Adding ultrasound guidance to the mix dramatically increases your chances of getting successful back pain treatment by eliminating trigger points.
Dry Needling for Back Pain in NYC
To get safe and effective back pain treatment in NYC, visit NYDNRehab, in midtown Manhattan. They use the highest resolution ultrasound imaging to view your body’s structures in motion, in real time, to get a full picture of the mechanisms of pain. If trigger points are detected, they can quickly and precisely perform dry needling during the same visit. If no trigger points are found, they will keep searching until they find the exact cause of your back pain and work with you to eliminate it, so you can get back as quickly as possible to your active lifestyle. NYDNRehab is the best place to go for back pain treatment and dry needling in NYC.
Liu, Lin, et al. “Evidence for dry needling in the management of myofascial trigger points associated with low back pain: a systematic review and meta-analysis.” Archives of physical medicine and rehabilitation 99.1 (2018): 144-152. https://www.sciencedirect.com/science/article/abs/pii/S0003999317304525
About the Author:
Dr. Lev Kalika has contributed to multiple research studies in the field of musculoskeletal ultrasonography and ultrasound guided dry needling. He is considered an international expert in integrative rehabilitation, sports medicine, injury prevention, athletic performance, and ultrasound guided dry needling. NYDNRehab is considered the most technologically advanced private physical therapy and rehabilitation clinic in the US.