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Dry needling with e-stim: How it Can Help Pain

Myofascial trigger points are areas of your muscle that have inflammation, and if you’ve ever had them, you know they can be a real pain.

One of the ways we treat trigger points is a physical therapy technique called dry needling, often used along with a more comprehensive physical therapy treatment plan. Thin needles without medication or injection (hence the term “dry”) are inserted through the skin directly into the affected muscle. The needles are either hollow-core hypodermic needles or solid filoform needles such as those used in acupuncture. Sometimes we add electrical stimulation (e-stim), an electrical current transferred through the dry needle that can help accelerate the process. I often use H-Wave® technology as a form of e-stim for my dry needling patients. On low frequency, the H-wave helps stimulate smooth muscle fibers to increase blood flow, which helps specific muscles or areas of inflammation heal faster.

It’s important to know that not all physical therapists can perform dry needling, and those that do must be certified according to guidelines by state. Here are some of the most frequent questions I get about dry needling:

What conditions can get treated with dry needling?
Dry needling can treat an enormous range of conditions, from muscular pain to carpal tunnel, to lateral epicondylitis, plantar fasciitis and much more.

What are the benefits of dry needling?
It’s a minimally invasive PT technique that is, at its core, instrument-assisted manual therapy. It has been shown to be powerfully effective decreasing muscle tension and tone (the muscle's resistance to passive stretch during resting state). This can improve your range of motion and relieve pain.

What are the benefits of dry needling with e-stim?
Dry needling on its own can be extremely effective as a treatment. The addition of e-stim acts as an adjunct to enhance the treatment effect for pain relief. E-stim helps to stimulate blood flow and provide analgesic effects to help numb the pain, often providing a more long-term effect.

How does the e-stim itself work?
Electrical stimulation helps treat pain by stimulating larger nerve fibers that supersede smaller nerve fibers that are causing pain. The larger nerves travel faster to override the smaller nerves similar to if you were to rub a sore spot; you would feel the rubbing instead of the pain. 

How many dry needling sessions are needed?
The number of treatments is really a case-by-case basis. Usually, a patient will see results or improvement after the first or second session.

Tyler Brady DPT, Cert. DN, is a physical therapist with OrthoCarolina University.

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