Myofascial dry needling and cupping are a part of my services. I offer it in my remedial treatments, I am happy to recommend these modalities if I think that a client is suitable to their therapeutic benefits. So read on to learn more about how myofascial dry needling and cupping works.
What is myofascial release?
Myofasica is referring to the soft tissues of the body. Particularly muscle and fascia. Fascia is a connective tissue that covers all our organs and muscles and groups of muscles. When we stretch we are stretching the fascia as well as the muscle. There are many myofascial release techniques including massage, stretching, heat, foam rolling, as well as cupping and dry needling.
What is cupping?
Cupping works by stretching skin and underlying tissues and as a result, causing a “trickle down” effect. Traditional cupping is a technique in which a glass cup is suctioned to the skin. It is an ancient practice found in Chinese, Hindu and Egyptian scriptures. Recently there has been a resurgence of interest with physical therapists using it for myofascial release. It is effective for musculoskeletal pain, headaches and migraines, sporting injuries, asthma, chronic cough and gastrointestinal disorders.
Glass cupping is safe when practiced safely. Side effects include the purple ‘bruising’ marks. Contraindications include open wounds, skin conditions such as acne, or sunburn.
A vacuum is created by inserting a flame briefly into the cup. The flame and treatment of cupping can look daunting. It is however, as painless as massage. Most clients describe it as a ‘stretching’ feeling. It works fast to reduce muscle and fascial tension.
Modern cupping techniques use plastic pump or silicone suction cups that do not require a flame for suction. Silicone and plastic cups are easy to use and massage with.
What is dry needling?
Dry needling is similar to acupuncture, that is to say they both use fine, solid needles, inserted into certain points in the muscle. From there, the two practices diverge.
Acupuncture follows Chinese philosophy of pressure points along energy channels, that run throughout the body.
Dry needling is a Western based practice pioneered by Janet G Trevell MD. Needles are inserted into the trigger point or ‘knot’ in the muscle to subsequently treat musculoskeletal pain.
Largely used by myotherapists, dry needling is becoming increasingly popular in Australia with other physical therapists, who are also seeing the benefits.
Dry needling a trigger point will consequently create an involuntary reflex in the muscle fibres. Blood, oxygen and inflammation will be forced into the muscle. It stimulates nerve endings in the muscle. Therefore resulting in a reduction in pain and release of tension in the muscle. Similarly to the response as with non-invasive trigger point therapy and deep tissue massage.
A number of different techniques are used by practitioners, for example; moving the needle in a ‘pecking’ motion, twisting or flicking the needle or just resting the needle.
Many studies have theorised reasons as to why dry needling and acupuncture reduce pain for example;
- stimulation of the spinal reflex arc;
- eliciting a local twitch response during the application of any needling technique;
- change in neuropathic condition;
- histamine release that causes local irritation and relaxation of the muscle;
- mechanically breaking up the tension in the tissue;
- decrease in stiffness of the muscle through an electrical event;
- bleeding causing release of so called platelet derived growth factors, which aids in the healing of the muscle;
- rebalancing the pain pH and biochemicals and neurotransmitters
Unfortunately however, no scientific study to date has reported the reliability of trigger point diagnosis.
What are the side effects?
Mild muscle soreness or ache is a common side effect after the procedure, bruising is also common. Typically soreness lasts between a few hours to a few days. Drinking water, resting, mineral salt baths, gentle stretching, and ice or heat over the affected area can all help with recovery in the same vein as deep tissue massage.
Complications
Like any health or medical procedure, there are possible complications. While complications are uncommon, they do sometimes occur. They must be considered prior to giving consent to the procedure.
- Any time a needle is used there is a risk of infection. However, using new, disposable and sterile needles, along with sterilising the skin, infections are extremely rare.
- If an artery or vein is punctured with the needle, a hematoma (or bruise) will develop. Usually the needles used are too fine to puncture the wall of an artery and bend around to avoid it. If any bleeding from a vein occurs, it is usually no larger than a pin-prick bleed and a fingertip size bruise.
- If a nerve is touched, it may cause paresthesia (a pins and needles sensation). This is usually brief, but it may continue for a couple of days. It is not dangerous and in some practices encouraged.
- Needles placed close to the chest wall, there is a rare possibility of a pneumothorax (air in the chest cavity). If you experience pain in the chest, pain on exertion, shortness of breath, dry cough or decreased breath sounds during auscultation up to half an hour after treatment, you should seek medical attention.
Contraindications and precautions for dry needling
- You should not receive needling if you are suffering from blood disorders such as haemophilia or Von Willebrands disease. Those with blood borne diseases need to disclose their condition to their therapist.
- Patients on blood thinning medications should not have needling. All medications should be disclosed to the therapist before treatment.
- Infants cannot have needling and children under 16 need parental consent.
- Those with cancer should seek advice from their practising physician before needling treatment.
- Patients with sensitivity or allergy to nickel or chrome may react to materials in the needles.
- Epileptics need particular attention and strong stimulation is contraindicated.
- Those with heart disease or recent cardiac surgery also cannot have needling.
Should I have cupping or dry needling?
Your physical therapist will advise you if they think you can benefit from either modality. Above all, it is your decision and have the right to refuse consent.
There is no specific number of treatments for patients with myofascial pain. Chronic conditions will may require ongoing treatments, while acute conditions may only require several sessons.
In addition, the amount of treatments will also depend on concurrent other medical conditions, compliance with any at home treatment, your age and physical condition. If your therapist does recommend it, then don’t be afraid to try the treatment and consider how you like the results.
