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Dry Needling for Joint and Muscle Pain Relief

What is Dry Needling?

The name “dry needling” comes from studies that were done to determine the effectiveness of injections. The studies showed that just putting a needle into a trigger point (a small, tight, tender area in a muscle) was just as effective as injecting a pain relieving or anti-inflammatory medication into the trigger point. Since nothing is injected with dry needling, we refer to it as “dry.”

Is Dry Needling the Same as Acupuncture?

While the two are often confused, they are actually different treatments. Dry needling is performed in the dysfunctional area, whereas acupuncture may be performed in the hand to address a headache, for example. Dry needling also focuses mainly on the treatment of musculoskeletal conditions.

How is Dry Needling Done?

First, the area of pain or tension will be assessed in order to locate trigger points. Then a needle will be placed into the muscle, and then the needle will be moved around in small movements that cause the muscle to activate – seen or felt as a twitch in the muscle. Once the twitching ceases, the needle is removed from the muscle.

What is the Purpose of Dry Needling?

Dry needling helps to relieve pain, help muscles relax, and improve function. Usually dry needling is used on tense muscles that are causing pain and affecting a person’s function. It is a very effective method and the results can be seen quicker than other treatments such as massage. The effects of dry needling can be felt after just one session but may take more than one to fully resolve the issue. It is used in conjunction with other treatments such as manual therapy and exercise.

Is Dry Needling Safe?

The risks associated with dry needling are minimal which makes it a safe procedure when performed by a trained practitioner. Physical therapists are regulated by each state in the training they must receive for dry needling before they can use the treatment on patients. Physical therapists also use clean technique, meaning they wear gloves and make sure that they use hand sanitizer and alcohol to sanitize the area being needled. Also, needles are kept in sealed packaging until use so that they are sanitary and safe for use. After a single use they are disposed of in a sharps container and are never reused.

Does Dry Needling Hurt?

Every person is different, and each muscle responds differently to dry needling. The process can be uncomfortable, but is usually not painful. The needle used for dry needling is a very thin needle similar to those used for acupuncture, so there is usually no pain associated with the needle being inserted into the skin. The muscle twitches associated with dry needling can be uncomfortable but typically are not painful. There may be some lingering soreness afterwards but this usually lasts less than 24 hours. Drinking plenty of water after having dry needling done can help to lessen this soreness.

Is Everyone Appropriate for Dry Needling?

While dry needling is a very effective and safe procedure for most people, not everyone is a candidate for it. There are certain precautions that can affect someone’s ability to have dry needling done (for example, over the area of a pacemaker). There is also a timeline of when dry needling is appropriate after surgery so that there is no increased risk for infection. Talk to your physical therapist to see if you’re appropriate for dry needling.

This blog was specially written by our friend and guest writer Rachel Zimmerman, DPT.

Rachel is clinic director at ATI Physical Therapy right here in Green Bay, WI. You can find out more about her clinic or find a location near you at ATIpt.com!

What You Need to Know: Plantar Fasciitis

Today’s blog post is courtesy of a special guest writer and expert on the topic of Plantar Fasciitis: Rachel Zimmerman DPT.

If you’ve ever experienced pain in the bottom of your foot, or in your heel, chances are it’s Plantar Fasciitis.

There is a common misconception that this is something you have to live with, but you don’t! The following advice will help alleviate your pain and get you back on your feet.

What is Plantar Fasciitis?

To understand what this condition is, we need to break it down into parts: plantar fascia and -itis. The plantar fascia is a structure in the bottom of the foot. It is a thin, white tissue similar to a ligament that sits between the skin and the muscle and extends from the heel to the toes. It provides stability to the foot. The suffix “-itis” is a Greek term meaning inflammation. So plantar fasciitis is inflammation of this tissue in the bottom of the foot.

What are the Symptoms of Plantar Fasciitis?

Plantar fasciitis typically presents as pain in the heel, usually on the inside part of the foot. The pain can also spread along the arch and along the bottom of the foot. The pain is usually worst during the first few steps after getting out of bed in the morning but can also occur after standing or walking for long periods of time.

What Causes Plantar Fasciitis?

Plantar fasciitis has multiple causes, but one of the most common is increasing your activity level too quickly! Also, having tight calf muscles, weak foot muscles, and/or wearing improper footwear.

What do I do if I believe I have plantar fasciitis?

Avoid aggravating activities: The most important thing you can do when you have an inflammatory condition is to avoid activities that increase your pain. Figure out which activities are aggravating it and modify them as you can. This does not mean to avoid activity altogether – just find activities you can do that don’t increase your pain level. This does not have to be long term, just while you are experiencing pain.

Stretch your calves: Tight calf muscles (the gastrocnemius and soleus muscles) can contribute to inflammation in the plantar fascia. Stretch your calves by sitting with your feet out in front of you with your knees straight, and place a towel around the ball of your foot. Pull back on the towel towards you until you feel a stretch in the calf. Hold for 30 seconds and then repeat a few times. You should feel a stretch, but not pain.

Strengthen your foot muscles: There are specific muscles in your foot that help to support your arch and take stress off the plantar fascia.

   • Great toe extension: Lift big toe, leaving other 4 on the ground. Repeat for 3 sets of 10.

   • Small toe extension: Lift 4 smaller toes, leaving big toe down. Repeat for 3 sets of 10.

   • Doming: Raise the arch of your foot, keeping toes down. Repeat for 3 sets of 10.

Change your footwear: Avoid shoes that are flat as these do not support your arch and can contribute to stress on the plantar fascia. Look for shoes that have a buildup on the inside of the shoe where your arch would be. Most shoe stores will be able to help find footwear that is appropriate for your feet, whether you need a stability shoe (which has more arch support than normal) or a neutral shoe (which has arch support but not as much as a stability shoe).

Ice: You can freeze a plastic water bottle, and then roll your bare foot over the frozen water bottle. It provides massage and ice, which will decrease the inflammation and will numb the pain temporarily. Do this for a few minutes at a time at most.

Consider orthotics: There are orthotics, or inserts for your shoe, that provide more stability for your arch. You can try basic orthotics from a drugstore or consider custom orthotics. A physical therapist, podiatrist, or orthotist can help you with custom orthotics.

**If your pain does not get better, consult a physical therapist! There are many other factors that contribute to plantar fasciitis that your physical therapist may be able to assess and treat.

This blog was specially written by our friend and guest writer Rachel Zimmerman, DPT.

Rachel is clinic director at ATI Physical Therapy right here in Green Bay, WI. You can find out more about her clinic or find a location near you at ATIpt.com!