My emphasis is always to reduce or eliminate pain in the short and long term. I have respect for each person and work create a warm and caring environment. I strive to educate each patient so that they can make healthy changes and become as self sufficient as possible in their healing process.
There are three primary techniques that I use to treat myofascial pain. Some patients have the manual therapy and some choose to add the dry needling as well.
Manual myofascial trigger point therapy. This hands-on technique involves using deep, held pressure to the trigger points. The goal is to release the contraction of the trigger point. Myofascial release techniques and stretching are a part of treatment. Often I will give stretches for you to do on your own. If you are interested in learning how to do self treatment I can teach you how.
Spray and Stretch technique. This technique uses a vapo-coolant spray to help increase the muscles ability to stretch.
Dry needling - also called intramuscular stimulation. Dry needling is an invasive procedure in which a solid filament needle is inserted into the skin and muscle directly at a myofascial trigger point. A myofascial trigger point consists of multiple contraction knots, which are related to the production and maintenance of the pain cycle. A physician referral is required for the dry needling (form).
More information about dry needling:
Is dry needling similar to acupuncture? - There are many similarities and differences between dry needling and acupuncture. In contrast to most schools of acupuncture, dry needling is strictly based on Western medicine principles and research. Erika Waly Bourne is not alicensed acupuncturist and does not practice acupuncture.
How does dry needling work? - The exact mechanisms of dry needling are not known. There are mechanical and biochemical effects. Based on the pioneering studies by Dr. Jay Shah and colleagues at the National Institutes of Health, we know that inserting a needle into trigger points can cause favorable biochemical changes, which assist in reducing pain. It is essential to elicit so-called local twitch responses, which are spinal cord reflexes. Getting local twitch responses with dry needling is the first step in breaking the pain cycle.
What type of problems can be treated with dry needling? - Dry needling can be used for a variety of musculoskeletal problems. Muscles are thought to be a primary contributing factor to the symptoms. Such conditions include, but are not limited to neck, back and shoulder pain, arm pain (tennis elbow, carpal tunnel, golfer’s elbow), headache to include migraines and tension-type headaches, jaw pain, buttock pain and leg pain (sciatica, hamstrings strains, calf tightness/spasms). The treatment of muscles has the greatest effect on reducing pain mechanisms in the nervous system.
Is the procedure painful? - Most patients do not feel the insertion of the needle. The local twitch response elicits a very brief (less than a second) painful response. Some patients describe this as a little electrical shock; others feel it more like a cramping sensation. Again, the therapeutic response occurs with the elicitation of local twitch responses and that is a good and desirable reaction.
Are the needles sterile? - Yes, we only use sterile disposable needles.
Can I do dry needling myself as part of my home program? - No, dry needling requires extensive training and should never be tried at home.
What side effects can I expect after the treatment? - Most patients report being sore after the procedure. The soreness is described as muscle soreness over the area treated and into the areas of referred symptoms. Typically, the soreness lasts between a few hours and two days.
What should I do after having the procedure done? - Our recommendations vary depending on the amount of soreness you have and on the individual response to the treatment. Recommendations may include applying heat or ice over the area, gentle stretches and modifications of activities.
How long does it take for the procedure to work? - Typically, it takes several visits for a positive reaction to take place. Again, we are trying to cause mechanical and biochemical changes without any pharmacological means. Therefore, we are looking for a cumulative response to achieve a certain threshold after which the pain cycle is disturbed.
Why is my doctor not familiar with dry needling? - In the US, dry needling is a relatively new method for treating myofascial pain and not everyone is already aware of this effective modality. Feel free to inform your doctor about this treatment option. It is upon all of us to educate others about new and innovative ways to treat pain. Some doctors may be familiar with a similar technique called trigger point injection. This technique uses larger needles and injects an anesthetic or other substance. Dry needling has the advantage of using thinner, less invasive needles thereby allowing more areas to be treated in a session.
Once I am feeling better, how often do I need to come back to maintain my progress? - The musculoskeletal system is under constant pressure from gravity, stress, work etc. A regular exercise program combined with good posture can prevent many problems. If the pain comes back, “tune-ups” are recommended to treat and prevent serious injuries.
