Introduction to Trigger Point Dry Needling

This is a great introduction to Dry Needling for anyone who might be interested in the topic.

This is also a pre-work course for live dry needling seminars by ODNS and IAOM-US in the United States, Europe, the Middle East, and Africa.

The online course contains:

  • Several pre-course readings with  quizzes.
  • Video lectures by ODNS staff on of the following topics:
  • historical overview
  • the neurophysiology of superficial and deep dry needling
  • ethics, precautions and contraindications
  • dry needling for radicular pain  
  • clinical reasoning with the role of agonists and antagonists.

The online course includes exam questions for each lecture.  This online portion must be completed within the month before the practical course, and will fulfill written examination requirements for dry needling courses.

Psst!  Hi!  This list will automatically update as you update the progress on the various modules. If you click these objectives, nothing will happen. 

1History of Trigger Point Theories
2Neurophysiology of Nocigenic Pain - Superficial Needling
3 Neurophysiology and the MTrP
4Ethics of Dry Needling
5Deep Dry Needling of the Lumbar Spine
6Clinical Reasoning in Dry Needling
7Obtaining Consent
8Required Reading: Description of Dry Needling in Clinical Practice
9Required Reading: Gerwin on Myofascial Pain Syndromes
10Required Reading: Trigger Point Dry Needling (Dommerholt et. al. 1)
11Required Reading: Myofascial Trigger Points (Dommerholt et. al. 2)
12Required Reading: Integrating Dry Needling (Shah et. al.)

Downloads

Links and References

  1. APTA.  2012. Physical Therapists and the performance of Dry Needling.  An educational resource paper. American Physical Therapy Association, Department of Practice.
  2. Baldry, P. 1992. Acupuncture, Trigger Points and Musculoskeletal Pain, Churchill and Livingstone
  3. Bandy WD, Nelson R, Beamer L 2017. Comparison of dry needling vs sham on the performance of vertical jump. Int. J. Sports Phys. Ther. Oct; 12(5): 747-751
  4. Brattberg, G, 1983. Acupuncture therapy for tennis elbow. Pain. Vol 16, pp 285-288
  5. Bruckner, P. & Kahn, D.  1993. Clinical Sports Medicine, McGraw Hill
  6. Butler, D. 1991.  Mobilisation of the Nervous System, Churchill Livingstone
  7. Calvo-Lobo C, Pacheco-da-Costa S, Martínez-Martínez J, Rodríguez-Sanz D, Cuesta-Álvaro P, López-López D, 2018. Dry needling on the infraspinatus latent and active myofascial trigger points in older adults with nonspecific shoulder pain: A randomized clinical trial. J Geriatr Phys Ther. 2018 Jan/Mar;41(1):1-13. doi: 10.1519/JPT. 79
  8. Castro-Sanchez AM, Garcia-Lopez H, Mataran-Penarrocha GA, Fernandez-Sanchez M, Fernandez-Sola C, Granero-Molina J, Aguilar-Ferrandiz ME., 2017. Effects of dry needling on spinal mobility and trigger points in patients with fibromayalgia syndrome. Pain Physician. 2017 Feb;20(2):37-52.
  9. Dommerholt J, Huijbrechts P.  2010. Myofascial trigger points. Jones & Bartlett.  Barb house London W6 7PA UK
  10. Fernández-Carnero J1, Gilarranz-de-Frutos L, León-Hernández JV, Pecos-Martin D, Alguacil-Diego I, Gallego-Izquierdo T, Martín-Pintado-Zugasti A., 2017. Effectiveness of Different Deep Dry Needling Dosages in the Treatment of Patients With Cervical Myofascial Pain: A Pilot RCT. Am J Phys Med Rehabil. 2017 Oct;96(10):726-733.
  11. Fields, H. 1987. Pain. McGraw Hill
  12. Filshie, J & White, A.  1998. Medical Acupuncture, Churchill Livingstone
  13. Foldes FF, Kuze S, Vizi ES, Deery A.  1973. The effect of temperature on neuromuscular performance, Journal of Neurological transmission 43: 27-45.
  14. Ga H, Ji-Ho Choi, Park C-H, Yoon H-J.  2007. Dry Needling of trigger points with and without paraspinal needling in myofascial pain syndromes in Elderly patients.  Journal of alternative and complementary medicine 13(6): 617-623
  15. Erwin, R.D., Shannon, S., Hong, C-Z. Hubbard, D.,  Gevirtz, R. 1997. Interrater reliability in myofascial trigger point examination.  Pain 69:65-73
  16. Gunn, C. 1989.  Treating Myofascial Pain: Intramuscular Stimulation, University of Washington
  17. Haanpaa M, Attal N, Backonja M, Baron R, Bennett M, Bouhassira D, Cruccu G, Hansson P, Haythornthwaite JA, Ianetti GD, Jensen TS, Kauppila T, Nurmikko TJ, Rice ASC, Rowbotham M, Serra J, Sommer C, Smith BH, Treede R-F.  NeuPSIG guidelines on neuropathic pain assessment. Pain 152: 14-27
  18. Hansson Y, Carlsson C, Olsson E.  2008. Intramuscular and periosteal acupuncture in patients suffering from chronic musculoskeletal pain.  Acupuncture in Medicine 26(4):214-223.
  19. Hong C-Z, Hsueh T –C. 1996.  Difference in pain relief after trigger point injections in myofascial pain patients with and without fibromyalgia. Arch Phys Med Rehabil 77(11):1161-1166.
  20. Hong CZ. 1994.  Lidocaine injection versus dry needling to myofascial trigger point.  The importance of the local twitch response. Arch Phys Med Rehabil 73:256-263
  21. Hong, C-Z., Kuan, T-S., Chen, J-T., Chen, S-M.  1997. Referred Pain Elicited by Palpation and by needling of Myofascial Trigger Points:  A Comparison. Arch Phys Med Rehabil 78:957-960
  22. Hooshmand, H. 1993.  Chronic Pain: Reflex Sympathetic Dystrophy, C.R.C. Press, Tokyo
  23. Kietrys DM, Palombaro KM, Azzaretto E, Hubler R, Schaller B, Schlussel JM, Tucker M.  2013. Effectiveness of Dry Needling for Upper quarter Myofascial Pain: A Systematic Review and Meta-Analysis.  Journal of Orthopaedic and Sports Physical Therapy Express 4668
  24. Kindyle L. Brennan, PT, PhD, Bryce C. Allen, MD, Yolanda Munoz Maldonado, PhD, 2017. Dry needling vs cortisone injection in the treatment of greater trochanteric pain syndrome: A noninferiority randomized clinical trial. Journal of Orthopaedic & Sports Physical Therapy, 2017 Volume:47 Issue:4 Pages:232–239 DOI: 10.2519/jospt.2017.6994
  25. Itoh K, Saito S, Sahara S, Naitoh Y, Imai K, Kitakoji H.  2013. Randomized Trial of Trigger Point Acupuncture Treatment for Chronic Shoulder Pain: A Preliminary Study. Journal of Acupuncture and Meridian Studies http://dx.doi.org/10.1016/j.jams.2013.02.002
  26. Liu QG, Liu L, Huang QM, Nguyen TT, Ma YT, Zhao JM. 2017. Decreased spontaneous electrical activity and achetylcholine at myofascial trigger spots after dry needling treatment; A pilot study. Evid Based Complement Alternat Med. 2017;2017:3938191. doi: 10.1155/2017/3938191. Epub 2017 May 16.
  27. McCutcheon L & Yelland M.  2011. Iatrogenic pneumothorax: safety concerns when using acupuncture or dry needling in the thoracic region.  Physical Therapy Reviews 16(2) 126-132
  28. Melzack & Wall.  The Challenge of Pain, Penguin
  29. Mense S, Simons DG, Hohiesel U, Quenzer B.  2003. Lesions of rat skeletal muscle after local block of acetylcholineesterase and neuromuscular stimulation.  Journal of applied physiology 94: 2494-2501
  30. Jimbo S, Atsuta Y, Kobayashi T, Matsuno T.  2008. Effects of dry needling at tender points for neck pain (katakori): near-infrared spectroscopy for monitoring oxygenation of trapezius.  Journal of Orthopaedic science, 13:101-106
  31. National Commission for Certification of Acupuncturists (1989) Clean Needle Technique for Acupuncturists
  32. Oschman, J. 2002.  Energy Medicine, The Scientific Basis. Churchill Livingstone.
  33. Rachlin, Edward. 1994.  Myofascial Pain and Fibromyalgia. Mosby
  34. Sedighi A, Nakhostin Ansari N, Naghdi S, 2017. Comparison of acute effects of superficial and deep dry needling into trigger points of suboccipital and upper trapezius muscles in patient with cervicogenic headache. J Bodyw Mov Ther. 2017 Oct;21(4):810-814. doi: 10.1016/j.jbmt.2017.01.002. Epub 2017 Jan 6.
  35. Shah JP, Phillips TM, Danoff  JV, Gerber LH. 2005. An in vivo micro analytical technique for measuring the local biochemical milieu of human skeletal muscle. J Appl Physiol 99(5):1977–1984 [Epub 2005 Jul 21].
  36. Shanmugam S, Mathias L., 2017. Immediate effects of paraspinal dry needling in patients with acute facet joint lock induced wry neck. J Clin Diagn Res. 2017 Jun;11(6):YM01-YM03. doi: 10.7860/JCDR/2017/26407.10079. Epub 2017 Jun 1.
  37. Simons, D. 1990.  Muscular Pain Syndromes, Advances in Pain Research, Volume 1, Raven Press.
  38. Simons, David. 2001.  Muscle Pain. Understanding its Nature, Diagnosis and Treatment. Lippincott, Williams & Wilkins.
  39. Stux, B & Pomerantz, B. 1987.  Acupuncture Textbook and Atlas, Springer Verlag.
  40. Treede RD, Jensen TS, Campbell JN, Cruccu C, Dostrovsky JO, Griffin JW, Hansson P, Hughes R, Nurmikko T, Serra J.  2008. Redefinition of neuropathic pain and a grading system for clinical use: consensus statement on clinical and research diagnostic criteria.  Neurology 70:1630-1635
  41. Tüzün EH, Gıldır S, Angın E, Tecer BH, Dana KÖ, Malkoç M. 2017.  Effectiveness of dry needling vs a classical physiotherapy program in patients with chronic low-back pain: a single-blind, randomized, controlled trial. J Phys Ther Sci. 2017 Sep;29(9):1502-1509. doi: 10.1589/jpts.29.1502. Epub 2017 Sep 15.
  42. Vulfsons S, Ratmansky M, Kalichman L. 2012.  Trigger Point needling: Techniques and Outcome.  Curr Pain Headache Rep DOI 10.1007/s11916-012-0279-6
  43. Webb, J. 1986.  Pain Control via Dorso-lumbar Sympathetic flow. Australian Journal of Physiotherapy 32(2).
  44. Wells, J.C.D. & Woolf, C.J. 1991.  Pain Mechanisms and Management, Volume 47(3). Churchill Livingstone.
  45. Westrick RB, Zylstra E, Issa T Miller JM, Gerber JP.  2012. Evaluation and treatment of musculoskeletal chest wall pain in a military athlete.  The international journal of Sports Physical Therapy 7(3): 323-332
  46. Wheeler, A.H, Goolkasian, P., Gretz, S.S.  1997. A randomised double blind prospective pilot study of Botulinum Toxin Injection for Refractory, Unilateral, Cervicothoracic, Paraspinal Myofascial Pain Syndrome.  Spine 23(15):1662-1664.
  47. http://www.musculoskeleton.anhb.uwa.edu.au – Useful anatomy website

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