"I refer you to a sports physician."
For two years I have been suffering from pain in my right calf muscle – I'm not sure of the cause. I trained six days a week and initially thought it was just an overloaded sore muscle. When the pain did not go away, I made an appointment with my doctor.
Now my family doctor suggested visiting another specialist. Since I was skeptical and nervous about collecting medical bills, I was reluctant to follow their instructions.
At this time, I had been through two years of tests ̵
Ultimately, my GP thought it was okay for me to exercise so my pain would not disturb my life. Nevertheless, after two years the pain disturbed me enough to visit at least one other doctor.
I went to see Cheri Blauwet, a physical medicine and rehabilitation physician at Brigham and Women's Hospital. She thought my pain was a chronic muscle strain. She recommended stretching with a splint while sleeping, as well as a more aggressive treatment with physiotherapist Philip Kidd.
During physiotherapy, Kidd recommended dry needle therapy. I had never heard of it, but was ready to try almost anything at the time. After only four physical therapy sessions, three of which included dry needle therapy, I only had minimal calf pain. Within three months of completing the physical therapy – I continued on my own – my calf pain had disappeared.
What is dry needle therapy?
Kidd explains that dry needles treat trigger points in the muscles. Trigger points are dense, painful muscle ligaments. "I can manually work with my hands to treat trigger points, but I found that dry needling is more effective," says Kidd.
The procedure is also faster than the manual massage, less than 5 minutes compared to 30 minutes or more.
"When I perform the procedure, I use a thin, solid needle to penetrate the trigger point and cause a twitching reaction. The twitching is involuntary, much like a reflex in the knee when a reflex hammer is used. The twitch means that I have found the right place. Then I will try to stimulate the muscle repeatedly, ideally until it stops twitching. The local sugar reaction is uncomfortable, but if we get to the point where it stops twitching, treatment usually works, "explains Kidd.
Kidd explains that the description of his patients, as dry needles feel, depends on the size of the needle muscle and the location. In general, people do not report great pain from the needle at all and often do not know when the needle is inserted. The twitching reaction is the cause of pain.
Kidd mentions, "I often tell people that the after-effects of the procedure may feel like sore muscles occur later when you train hard in the gym."
Science behind dry needle therapy
"Science Dry-needling is not fully understood yet, but there are many theories, "explains Kidd. "It is possible that the needle deforms the muscle fiber or destroys a disturbed motor endplate."
A trigger point is usually due to muscle overload and overuse, which is common in sports injuries. "By using dry needling, you may be able to reduce nociceptive input, increase muscle activation, and improve the malleability of the muscle," explains Kidd.
Blauwet explains that it can cause tension when athletes have biomechanical ligaments in the muscles. "The actual tissue density changes in the muscle itself and in the environment of the muscle. In this case, it is difficult for the muscle to release itself. It's getting chronic and it's very hard to get better, "she explains.
Dry needling helps to initiate a process in which you release this chronic tension and improve the tissue density and the focal pH of this area improves slowly.
She also emphasizes the importance of participating in physical therapy in conjunction with dry needle therapy. In this way, you can address the underlying reasons why the muscle strain occurred in the first place. "You can set the trigger point, but if you can not pinpoint the reason why the trigger point was there, it will simply reappear," says Blauwet.
Do you need a prescription for dry needle therapy?
You do not need a doctor's prescription to receive dry needle therapy. "Some doctors I work with are currently prescribing it. I think this is probably the most common way to refer patients with chronic headaches, "says Kidd.
The rules for performing dry needle therapy vary from state to state. In some states, physiotherapists can do a dry needle. "Some states do not allow it and there are many groups working to change that," says Kidd.
Kidd states that only a physical therapist who has participated in the full certification process can use the technique at Brigham and Women's Hospital.  Are there any concerns that people should be aware of?
There are some contraindications to consider before performing dry needle therapy.
Kidd mentions that people suffering from local skin lesions such as cellulitis, psoriasis and local or systemic diseases infections should avoid dry needling. Dry needling should not be performed over areas with swelling, deep muscles in abnormal bleeding, or areas of vascular disease, including varicose veins.
People with weakened immune systems should not use dry needles. And it is not possible to need to dry over implant areas such as breasts, calves or buttocks.
"There is no evidence to support this, but needling during the first trimester of pregnancy should be avoided," says Kidd.
What is the success rate?
Kidd has found that success rates vary. "I've been using this method for about two years and some people with surprisingly long periods of pain can be significantly better after one or two sessions while others see modest improvements," says Kidd.
Kidd says that it rarely happens that a patient does not find help with dry needles. "I think it's most effective to find a trigger point that reproduces the pain the patient has a problem with palpation," says Kidd. If there are no trigger points, dry needling will fail.
Dry needling can be added to physiotherapy and medical treatments. Kidd also does not recommend using dry needle therapy alone, but in conjunction with physical therapy and stretching.
"Dry needling is very effective for trigger points, but often [these aren’t the only] a problem. In the long run, I can have a better success if I can educate the patient about pain science and a practice prescription. This last part is important because its success is not just in my hands. I want to give them the tools to manage themselves. Dry needling is a means of getting them there.
Blauwet says, "I really like dry needle therapy because it's so safe overall. It uses the mechanical effects of a needle instead of having to inject everything, which could have side effects. Cortisone, for example, has its uses, but you do not want to put it in muscle when you do not need it. Since you are not injecting cortisone or anything else that has harmful side effects, you can repeat it. "
Blauwet does not learn anything about dry needles from all her patients, as she received it during physiotherapy, but she has received feedback that this is often helpful. She believes that it can be very effective if done in the right circumstances.
An overview study from 2016 examined earlier research on dry needling and found that it effectively relieves pain in the lower body and is recommended for other problems. like myofascial pain. Another study found no difference to reducing short-term pain when used in dry needling.
My takeaway meal
For more than two years, I have experienced pain, but after only three dry needling sessions, my pain has been greatly reduced. I think dry needling helped me accelerate the healing process, which meant less money for co-pays and less time for doctor visits.
The first physiotherapist I saw massaged my calf, but it hurt for 15 minutes and I did not feel any improvement. The dry needle felt like a stinging pain for about 30 seconds, and then my calf muscle felt like a pulled muscle for about a day.
If necessary, I would try again. If you think this may be of benefit to you, look for state-certified physiotherapists who have a Dry Needle specialist. She is married and mother of twins and a daughter. Her writing has been published in Parents Magazine, Upworthy, "Chicken Soul for the Soul: Count Your Blessing" and in Teen Magazine. You can find them on Twitter .