Many patients who are new to The One80 System have tried trigger point dry needling treatments with little to no success. Others ask why we don’t offer it. Here are 5 reasons that address both situations.
1. Experts don’t know what trigger point dry needling (TDN) treats.
PTs and chiropractors that use TDN claim to be treating “trigger points.” A common definition for a trigger point is, “a hard and/or tender part of a muscle where the fibers are balled together causing local or referred pain.” This is actually different than a “tight muscle” where the length of the muscle belly is shortened. The problem is, although the theory behind trigger points has existed since the 80’s, not even the “experts” have been able to tell exactly what they are, what causes them, or if they really exist. If they don’t exist, or if we can’t find or clearly define them, how and why are people sticking needles in them?
2. Nobody agrees on what it does.
Speculation runs rampant on what actually happens when needles are stuck into muscles. Hypotheses suggest that needling techniques; stimulate fibers, may activate inhibitory interneurons, causes opioid mediated pain suppression, activate inhibitory systems to block noxious stimulus, disperse the excessive ACh in the tissue to relax muscle fibers, enhances the release of ACh from nerve terminals, cause micro-trauma and bleeding/inflammation to help promote healing, results in increased ACh receptors at the neuromuscular junction, releases various chemicals at the motor end plate… Does that sound like a treatment strategy or a guessing game?
3. Research has shown little to no efficacy.
Although a Google search will uncover plenty of case studies and testimonials claiming miraculous results with TDN, published studies differ. A systematic review of the literature with meta-analysis published in Physiotherapy in 2017 concluded that, “There is very low evidence to support the use of TDN in the shoulder region for treating patients with upper extremity pain or dysfunction.”
4. Let’s pretend we knew trigger points existed, knew how to find them, knew exactly what they were, knew what caused them, and we also could prove at the physiological level that TDN decrease pain and cause muscles to relax… would masking pain and forcing muscle relaxation be good?
Remember, at One80 we NEVER mask pain (that is what tells us there is a problem somewhere) and we NEVER force muscles to relax (because muscle can’t function normally when forced to relax). So, even if TDN did what clinicians claim it does, it would not address or reverse the root cause of your problem.
5. If the entire TDN thing is bogus, why does every PT clinic other than One80 do it? It all comes down to the equation TDN = $$$. Here is a line from a blog written by a clinician who works for one of the biggest providers in the TDN continuing education realm. “…while there is a paucity of evidence, TDN probably works in some instances-likely more to “meaning effect” and placebo than anything else, which of course is fine…” That’s right, even the experts in the TDN world know its nothing more than placebo. But, if PTs want to shell out thousands of dollars to learn it, and referring physicians want patients to get it, and patients will pay for it, does it really matter that patients don’t know any better? We think it does, and that’s why we don’t offer it.
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