Real-time ultrasound imaging is currently used extensively in medicine. It provides a safe, cost-effective and readily accessible method of examination of various organs and tissues. One area where ultrasonography has proved to be useful is investigation of musculoskeletal pathology. Tissues that can be imaged include muscles, tendons, joints, ligaments and bursae. One of the most useful features of real-time ultrasound imaging is that movement of anatomical structures can be observed as it actually occurs. This has allowed development of a new application of real-time ultrasound imaging for rehabilitation that involves observation of muscle contraction to provide feedback. An ability to image deep muscles is an advantage of the technique, and use of ultrasound imaging has been successfully incorporated in assessment and facilitation strategies for neck, back, shoulder, knee and a variety of other pain sources. It is a remarkable tool when used in conjunction with IMS (dry needling) to target deep structures that that can often be the cause of altered function and/or pain.More
Trigger point dry needling, also referred to as intramuscular stimulation (IMS) and/or intramuscular therapy (IMT) is an invasive procedure in which an dry needles are inserted into the skin and muscle. It is a physical therapy modality used in conjunction with other therapies to treat myofascial pain.
Dry needling involves insertion of filament needles into the muscle that have contracted and become shortened. These shortened muscles compress and irritate the nerves. The aim of dry needling is to achieve a local twitch response to release muscle tension and pain. Dry needling is an effective treatment for chronic pain, such as chronic low back pain and sciatica symptoms.
A healthy muscle feels very little discomfort with insertion of this needle. However, if the muscle is sensitive, shortened or has active trigger points within it, the subject will feel pain as a sensation like a muscle cramp -‘the twitch or cramping response’. This sensation lasts only a few seconds.
Intramuscular dry needling can reduce pain, while increasing flexibility and range of motion by:
•stretching receptor in the muscle by stimulation, producing a relaxation or lengthening
•the needles cause a small injury that draws blood to the area, initiating the natural healing process
•the treatment creates an electrical potential in the muscle to make the nerve function normally again
The number of treatments required depends on several factors: your general health, the duration and extent of your condition, how much scar tissue there is and how quickly your body can heal. The rate of healing also depends on the condition of your nerves. If the pain is of recent origin, one treatment may be all that is necessary. The average person responds very well within 4 to 6 treatments.
IMS has a remarkable success rate, as proven by the elimination of symptoms and signs, even for chronic pain.More
Intramuscular Stimulation (IMS) or Functional Dry Needling (FDN) is a therapeutic treatment procedure that involves multiple advances of a filament needle into the muscle in the area of the body which produces pain and typically contains a ‘trigger point’. There is no injectable solution and typically the needle which is used is very thin. Most patients will not even feel the needle penetrate the skin, but once it has and is advanced into the muscle, the feeling of discomfort can vary from patient to patient.
Usually a healthy muscle feels very little discomfort with insertion of the needle; however, if the muscle is sensitive and shortened or has active trigger points within it, the subject may feel a sensation much like a muscle cramp — which is often referred to as a ‘twitch response’. The twitch response also has a biochemical characteristic to it which likely affects the reaction of the muscle, symptoms, and response of the tissue.
Finding a Trigger Point
The patient may only feel the cramping sensation locally or they may feel a referral of pain or similar symptoms for which they are seeking treatment. A reproduction of their pain can be a helpful diagnostic indicator of the cause of the patient’s symptoms. Patients soon learn to recognize and even welcome this sensation as it results in deactivating the trigger point, thereby reducing pain and restoring normal length and function of the involved muscle. Typically positive results are apparent within 2-4 treatment sessions but can vary depending on the cause and duration of the symptoms, overall health of the patient, and experience level of the practitioner.
Dry needling is an effective treatment for acute and chronic pain, rehabilitation from injury, and even pain and injury prevention, with very few side effects. This technique is excellent in finding and eliminating neuromuscular dysfunction that leads to pain and functional deficits.More