Bill Klaproth (Host): Dry needling is a technique physical therapists use to treat muscular tension and spasm. The technique uses a dry needle – one without medication or injection – inserted through the skin into tight areas of the muscle known as trigger points. And here to talk with us about dry needling is Kristin Dorio, a physical therapist at Tidelands Health. Kristin, thank you so much for your time. So, dry needling – is this a new technique?

Kristin Dorio (Guest): No, it’s been around for quite a while, but it's certainly becoming much more popular in the area. You know, a lot more therapists are incorporating this to their daily practices and finding that we're getting excellent results and outcomes with patients.

Bill: So, dry needling – is this acupuncture?

Kristin: No. It is different. Actually, the only similarity between the two is the kind of needles we use. We both use a solid filament needle, but the evaluation process, the actual practice of treatment, and our goals are much different. With acupuncture, they are kind of looking more for an alignment of the meridians of the body – looking for more – a little bit more of a holistic approach whereas dry needling looks a little bit more at the person’s function, looking at tight muscles, specifically, and what those tight muscles are doing to impede somebody’s ability to do their daily activities basically.

Bill: So, in acupuncture, we’ve seen the picture of people lying there, and they’ve got a whole, you know, assortment of needles in their body. So, what is the process of dry needling? Is it just one needle, and you're going in looking for that trigger point?

Kristin: Pretty much. You know, as we do our evaluation process, we really look at all the muscles that could be contributing to why somebody’s coming to us because of pain – whether it's headache, shoulder pain, neck pain, back pain. You know, we really take a good, comprehensive look at what muscles that could be tight and contributing to their pain. So sometimes it is just one muscle. Other times, you know, I see multiple muscles that could be contributing to somebody’s problems.

Bill: Right. Because they're all tied together and the spasm in the neck could be that really tight trigger point muscle in the shoulder. So you're trying to…

Kristin: Absolutely.

Bill: …identify that. So, how do you know who is a good candidate for dry needling? I mean, there's massage therapy, too. There’s other types of physical therapy. When do you say, mmm, dry needling might be right for this person?

Kristin: Well, usually, we try and exhaust their treatment techniques. You know, to approach, you know, a patient about dry needling, some are very willing and eager to try any kind of technique. Other patients usually want to try a little bit more of a conservative approach, and so we will try other modalities – massage, manual techniques first. But usually a good candidate for this procedure would be somebody who’s not responding to that, but yet we know that they have these trigger points and tight muscles. So, you know, I do a lot of explanation, education for patients so they’re really well-informed about it prior to doing the procedure.

Bill: So, what is the procedure like? Can you explain that to us?

Kristin: Sure. Sure. What I like to do with a patient – say for example they're having some neck pain or spasms. You know, I’ll first look at their mobility and motion—how they're moving their neck forward, to the side, rotating, things like that. Then, usually have them lie down. You know, everything is certainly sterile, brand new needles and all that, and I’ll explain to the patient's exactly what muscles we're doing and step by step what we're doing. We’ll do the technique, and I’ll have them sit up afterwards, and I’ll take them through the same motions of their neck – looking at their motion and what we come to see usually is that that motion is immediately better. And so that’s the neat part about it – is that we get to see those benefits occurring right before our eyes, and it's a lot of education afterwards of maintaining that range and stretching to hopefully maintain those gains.

Bill: So the results are generally instant?

Kristin: Yes. Sometimes they are. Sometimes if we have muscles that have kind of been in a long-standing tight position for, you know, it may take a couple visits. You know, and sometimes, if there's multiple factors that may be restricting somebody’s motion or mobility, sometimes, we don’t see as much improvement immediately, but may take a couple more visits.

Bill: So, generally, how many visits would a person need to have of dry needling?

Kristin: I usually tell them that for the same muscle group, I usually don’t needle it any more than three or four times. If we haven’t seen any kind of benefit within those couple visits, then we probably won’t. You know, so it kind of forces us to look elsewhere – ok is there other muscles that might be contributing to it? You know, is there something more going on? Is there something more musculoskeletal that might be limiting their motion?

Bill: So, is it painful when you think of needles? I would imagine people don’t want to go through it because we associate needles with pain. Is it a painful procedure?

Kristin: It can be uncomfortable, especially if you have a very tight muscle. You know, so I do a lot of education, letting them know, and by all means, I tell them if they feel as though it is uncomfortable, we can stop at any point. It does tend to be uncomfortable because the needles will penetrate through the muscle tissue, and especially if we elicit a trigger response, which is a little bit of a twitch of the muscle, that tends to be uncomfortable. It’s almost like a little cramping. You know, that may be uncomfortable to some patients. But, for the most part, it's a very quick procedure. Sometimes we will leave the needles in. Sometimes, it's just a matter of moving through the muscle with the needle, but usually not too uncomfortable.

Bill: And I mentioned trigger points earlier, and you just mentioned a trigger response. Can you explain to us what trigger points are?

Kristin: Trigger points are knots within the muscle that contribute to pain, decreased flexibility, and also decreased muscle function, and they're almost literally knots within the muscle, and you know, if you’ve ever had one, you’ve kind of felt it and rolled your finger over it, and usually it comes from, you know, repetitive stress or faulty posture – things like that. And so, you know, we try and get in there as therapists to work out those spots, but sometimes it needs a little bit more and so that’s when the dry needling comes into play. It is usually most beneficial to help release that trigger point and get it back – get that muscle back to its normal resting length.

Bill: Well, it seems like if you use dry needling to release that trigger point, even temporarily, where the person can start stretching then manually, that might be a great way to start releasing that muscle and stop the spasm.

Kristin: Absolutely. So, it kind of opens the gate for us. Most of our treatments would not just be dry needling in isolation. We’re going to follow it up with the manual techniques, stretching, and a lot of education to prevent it from coming back because if somebody were to go right back to some bad postures or bad habits, those trigger points are going to come right back again. So, that’s when, you know, some education, exercise, things like that really come into play to make sure, you know, this is the last time the person – or the patient —has to worry about this.

Bill: I like how you said that – open the gate – because that’s a great way to unlock that trigger point, and it's tough to do sometimes, right?

Kristin: Yes. Yes, especially if somebody has a lot of tension, you know, and sometimes manually trying to release a trigger point, it's uncomfortable. So, you know, we try and make it as a quick – quick as possible process — and with the least amount of discomfort, but yet kind of open that gate to get them to, you know, feeling better.

Bill: Kristin, thank you so much for your time today. Can you tell us why someone should choose Tidelands Health for their physical therapy needs?

Kristin: Well, along with myself, we have multiple therapists at this clinic with, you know, comprehensive backgrounds, and you know, multiple treatment techniques that would certainly help any of our patients that would come to the door. You know, we have lots of resources and programs to help – myself and there is one other therapist in HealthPoint in Pawley’s Island that also does dry needling. So, we kind of take a good approach at trying to help patients and getting them feeling better and have a lot of programs at our access that we can use to help people.

Bill: So important, Kristin, thank you, again. For more information about Tidelands Health physicians, services, and facilities, visit tidelandshealth.org. That’s tidelandshealth.org. This is Better Health Radio. I'm Bill Klaproth. Thanks for listening.