Posts tagged dry needling
Dry Needling Improves Pain, Mobility, and Function In Patients With Hip Arthritis
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Hip arthritis is a painful condition causing pain, loss of range of motion, and lost function in many middle to older aged adults. The pain from hip arthritis is multifactorial in nature arising from the cartilage and joint surfaces as well as the surrounding soft tissues. Physical Therapy consisting of manual therapy and strength training remains the first line treatment for patients with hip arthritis. High level exercise has previously been shown to preserve the patient’s native hip delaying the need for a total joint replacement. Previous research has documented the benefits of joint mobilization and manipulation in patients with hip arthritis, but recent research has highlighted the benefits of dry needling by Physical Therapists in this condition.

Ceballos-Laita and colleagues conducted a double blind, randomized controlled trial on the effectiveness of dry needling in patients with hip arthritis (Musculoskelet Sci Pract. 2019). 30 patients were randomized to either dry needling or a sham needling group for 3 treatment sessions. Patients’ pain, function (gait and strength), and range of motion was assessed at baseline at at the conclusion of the treatment sessions. Authors found significant improvements in pain, range of motion, and function after the dry needling treatment compared to the sham group. Interestingly, the sham group reported increased pain and decreased hip range of motion at the conclusion of the trial. This study indicates dry needling may be included in a Physical Therapy treatment plan for patients with hip arthritis to reduce pain and facilitate a rapid transition to an exercise program.

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How Does Needle Depth Impact Treatment Effects From Dry Needling?
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Dry needling is a treatment provided by Physical Therapists to relieve a patient’s muscular pain and associated symptoms. This intervention can be performed in both extremity and spinal regions within the body. Current research continues to investigate the mechanisms behind its’ effectiveness, as well as, the most appropriate patient populations and diagnoses for its’ utilization. In addition, authors are trying to determine which parameters of the treatment such as needle placement, needle number, duration of treatment, utilization of electrical stimulation and needle depth may be modified for optimal treatment effects.

Griswold and colleagues reviewed the available evidence behind needle interventions for spinal pain to determine if depth of needle placement influences treatment effects (JMMT. 2019). Authors included 12 studies in the systematic review and 10 studies in the meta analysis. They reported both superficial and deep dry needling improved pain but significantly better outcomes on pain were found for utilization of deep dry needling. In addition, there was a greater effect when needles were placed in the area of pain compared to a distal site on the body.

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Dry Needling Improves Effectiveness of Physical Therapy Treatments for Heel Pain
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Plantar fasciitis is the most common cause of plantar heel pain estimated to affect 10% of the general population through their lifetime. Proper nomenclature of the pathology is dependent on the tissue involved and how long the symptoms have been in existence. “Fasciitis” suggests an acute inflammatory response, where “fasciosis” illustrates a chronic degenerative response without inflammation. Both terms describe impairments to the insertion of the plantar fascia and/or toe flexors as they attach to the medial heel. Both pathologies are also categorized by increased pain on the inside/plantar aspect of the heel, namely during the “first steps” in the morning or increased weight bearing activities throughout the day.

Manual therapy with exercise has proven to be the best course of action to manage pain and dysfunction of plantar fasciitis, however a recent study investigated the benefit of Electrical Dry Needling (EDN) as an adjunct treatment (Dunning et al. PLOSone, 2018). The study divided 111 participants into 2 groups (standard treatment without EDN vs. standard treatment with EDN). Both groups received up to 8 treatments in a 4-week period. The authors concluded the EDN group’s pain and disability improved significantly at 3 months after treatment compared to treatment without EDN.

To learn more about how Electrical Dry Needling can decrease pain and improve function, contact your local, trusted Physical Therapist.

Addition of dry needling improves the effectiveness of Physical Therapy treatments for knee arthritis
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Knee arthritis is one of the leading causes of disability and reduced activity in the United States.  Physical Therapy interventions, including manual therapy and exercise, remain the foundation of conservative care for this diagnosis.  When combined, manual therapy and exercise, have been shown to reduce pain, stiffness, weakness, and disability in patients with knee arthritis.  These interventions are superior to exercise alone, a wait and see approach, or usual care management.  Recently, dry needling, as well as, dry needling with electrical stimulation have been utilized clinicailly in the treatment of knee arthritis.  Authors report improved circulation, joint lubrication, and levels of inflammation following dry needling with electrical stimulation.  

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  A recent research article in the Clinical Journal of Pain randomized 242 patients with knee arthritis to one of two groups, manual therapy and exercise or manual therapy and exercise combined with dry needling and electrical stimulation.  Participants completed similar manual therapy and exercise programs and were seen 1-2 times per week over a 6 week period.  Authors reported significantly better pain and disability scores at 6 weeks and 3 months in the participants who also received dry needling.  In addition, participants receiving dry needling were almost twice as likely to have stopped their pain medication use.  As expected, a higher percentage of participants in the dry needling group reported a significant improvement in perceived recovery.  

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Calf Dry Needling Improves Overhead Squat Depth
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Dry needling is a commonly utilized Physical Therapy intervention which targets taught, tender bands of muscle tissue.  This effective treatment has been previously shown to reduce muscle pain and improve muscle performance and function.  In our Boulder Physical Therapy clinic we commonly see an immediate improvement in muscle length and mobility following the dry needling intervention.  A recent study examined the effectiveness of dry needling on functional movement.  

Lake and colleagues enrolled 30 healthy males into their study published in the International Journal of Sports Physical Therapy (2018).  Participants were then randomized to one of three groups: calf dry needling, stretching, or dry needling and stretching.  Each participant performed a series of lower quarter functional movements both before and after the treatment, as well as, 4 days post treatment.  Authors reported a significant increase in overhead squat depth following dry needling of the calf musculature.  This effect is likely secondary to improved ankle bend or dorsiflexion allowing each participant to squat deeper on reassessment.  No significant differences were noted in the Y balance functional testing.

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Including Dry Needling More Cost Effective Than Exercise Alone For Shoulder Pain
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Shoulder impingement is the most common cause of shoulder pain and is commonly treated with Physical Therapy interventions including upper body strengthening and manual therapy.  Dry needling is gaining traction in both clinical practice and the medical research as an effective treatment option for musculoskeletal pain.  When combined with other forms of manual therapy, including joint mobilization and manipulation, and exercise, dry needling offers patients an effective choice for their symptoms.  A recent article examined the cost effectiveness of adding dry needling treatments to exercise for patients with shoulder impingement.

Fifty patients with subacromial impingement were randomized to shoulder strengthening (twice per day x 5 weeks) or shoulder strengthening and dry needling (Arias-Buria, J. Pain Med. 2018).  Patients undergoing dry needling treatments received dry needling to the shoulder complex on their 2nd and 4th Physical Therapy sessions.  Patients in the exercise only group made more visits to their physicians and received higher amounts of outside treatments for their symptoms.  In addition, patients in this group lost more time from work and reported lower satisfaction levels than the dry needling and exercise group.  Authors concluded dry needling was a cost effective treatment for shoulder pain due to its' ability to reduce time lost from work.

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