Trigger Point Dry Needling: An Evidence and Clinical-Based Approach

533 Pages·2018·29.68 MB·English

by  Jan Dommerholt, César Fernández de las Peñas

Trigger Point Dry Needling
An Evidence and Clinical-Based Approach
SECOND EDITION
Jan Dommerholt, PT, DPT, MPS
Myopain Seminars, LLC, Bethesda, MD, USA
Bethesda Physiocare, Inc, Bethesda, MD, USA
César Fernández-de-las-Peñas, PT, PHD, Dr. SciMed
Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation of
Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
Esthesiology Laboratory of Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
Centre for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg
University, Aalborg, Denmark
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Table of Contents
Cover image
Title page
Copyright
Preface
Acknowledgements
Dedication
Contributors
Part 1: Basis of Trigger Point Dry Needling
Chapter 1: Basic Concepts of Myofascial Trigger Points
Myofascial trigger point overview
Neurophysiological basis of muscle referred pain
Neurophysiological aspects of myofascial trigger points
Chapter 2: Proposed Mechanisms and Effects of Trigger Point Dry Needling
Introduction
Mechanisms and effects of trigger point dry needling
Summary
Chapter 3: Dry Needling for Fascia, Scar, and Tendon
Introduction
Fascia and scar dry needling
Dry needling and tendon
Chapter 4: Dry Needling for Neurological Conditions
Introduction
Spasticity and muscle tone
Pain in neurological conditions
Botulinum toxin a for spasticity and related pain
Dry needling for neurological conditions
Clinical reasoning for dry needling in neurological conditions
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Clinical guidelines for dry needling in spasticity
Mechanisms of dry needling on neurological conditions
Clinical considerations
Chapter 5: Trigger Point Dry Needling: Safety Guidelines
Acknowledgement
Safety considerations
Trigger point dry needling: safety
Hygiene
Contraindications and precautions
Anatomical considerations
Procedural safety issues
General guidelines for principles of practice
Patient selection
Principles of dry needling application
Electrical stimulation via dry needles
Summary
Chapter 6: Dry Needling Across Different Disciplines
Introduction: scope of practice
Dry needling by multiple disciplines
Opposition to dry needling by nonacupuncturists
Summary
Part 2: Clinical and Evidence-Informed Approach of TrP Dry
Needling
Chapter 7: Deep Dry Needling of the Head and Neck Muscles
Introduction
Clinical presentation of trigger points in head and neck pain syndromes
Dry needling of head muscles
Dry needling of neck–shoulder muscles
Chapter 8: Deep Dry Needling of the Shoulder Muscles
Introduction
Clinical relevance of myofascial trigger points in shoulder pain syndromes
Dry needling of the shoulder muscles
Chapter 9: Deep Dry Needling of the Arm and Hand Muscles
Introduction
Clinical relevance of trigger points in arm and hand pain syndromes
Dry needling of the arm and hand muscles
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Chapter 10: Deep Dry Needling of the Trunk Muscles
Introduction
Clinical relevance of trigger points in syndromes related to the trunk
Dry needling of the trunk muscles
Chapter 11: Deep Dry Needling of the Hip and Pelvic Muscles
Introduction
Clinical relevance of trigger points in syndromes related to the pelvis
Clinical relevance of trigger points in syndromes related to the hip and thigh
Dry needling of the abdominal, hip, pelvis, and thigh muscles
Chapter 12: Deep Dry Needling of the Leg and Foot Muscles
Introduction
Clinical relevance of trigger points in leg and foot pain syndromes
Dry needling of the leg and foot muscles
Part 3: Other Dry Needling Approaches
Chapter 13: Superficial Dry Needling
Introduction
Superficial dry needling
Variable reactivity to needle-evoked nerve stimulation
Procedure recommended for the carrying out of superficial dry needling
The initial consultation
Systematic search for trigger points
Muscle stretching exercises
Measures to be taken to prevent trigger point reactivation
Summary
Chapter 14: Dry Needling from a Western Medical Acupuncture Perspective
Introduction and historical development
Neurophysiological mechanisms of the technique
Clinical research
Clinical application of the technique
Summary
Chapter 15: Intramuscular Stimulation
Introduction
Neurophysiological mechanism of gunn intramuscular stimulation
Clinical application of gunn intramuscular stimulation
Treatment
Case study example
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Chapter 16: Fu’s Subcutaneous Needling
Acknowledgement
Origin of fu’s subcutaneous needling
Development of fu’s subcutaneous needling
Fu’s subcutaneous needling manipulations
Precautions, contraindications, and management of side effects
Factors that influence fu’s subcutaneous needling effects
Fu’s subcutaneous needling features
Index
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Copyright
© 2018 Elsevier Limited. All rights reserved.
First edition 2013
Second edition 2018
No part of this publication may be reproduced or transmitted in any form or by any means,
electronic or mechanical, including photocopying, recording, or any information storage and
retrieval system, without permission in writing from the publisher. Permissions may be sought
directly from Elsevier’s Rights Department: phone: (+ 1) 215 239 3804 (US) or (+ 44) 1865 843830
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request online via the Elsevier website at http://www.elsevier.com/permissions.
ISBN 978-0-7020-7416-5
e-book 978-0-7020-7518-6
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from the Library of Congress

Notice
Knowledge and best practice in this field are constantly changing. As new research and experience
broaden our knowledge, changes in practice, treatment and drug therapy may become necessary or
appropriate. Readers are advised to check the most current information provided (i) on procedures
featured or (ii) by the manufacturer of each product to be administered, to verify the recommended
dose or formula, the method and duration of administration, and contraindications. It is the
responsibility of the practitioner, relying on their own experience and knowledge of the patient, to
make diagnoses, to determine dosages and the best treatment for each individual patient, and to
take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the
Editor assumes any liability for any injury and/or damage to persons or property arising out of or
related to any use of the material contained in this book.
The Publisher
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Printed in China
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Preface
Jan Dommerholt , Bethesda, MD, USA
César Fernández-de-las-Peñas , Madrid, Spain
Since the publication of the first edition of this book, the utilisation of dry needling in clinical
practice has expanded dramatically throughout the world. Whereas initially mostly
physiotherapists, chiropractors, and (Australian) myotherapists used dry needling, more recently,
other healthcare providers have also started to incorporate dry needling into daily patient
management. In many jurisdictions occupational therapists, athletic trainers, acupuncturists,
osteopaths, dentists, physicians, and veterinary physicians are using dry needling for a wide variety
of patients. Many professional sports teams in the United States and Europe are employing ‘dry
needlers’ in the care of their athletes. Organizations such as the Association of Tennis Professionals
and the Women’s Tennis Association rely on physiotherapists to provide comprehensive therapy
services that include dry needling. In the United States dry needling has even made its way into the
emergency rooms with one hospital reporting a decrease of over 50% in opioid prescriptions in the
year after the introduction of dry needling for musculoskeletal pain and dysfunction as reported by
National Public Radio (All Things Considered, 20 February 2018). Dry needling is a cost effective
remedy as part of a multimodal therapy program.
The range of dry needling applications has also expanded. Whereas most clinicians are targeting
trigger points, dry needling is increasingly used for the treatment of individuals with tendinopathy,
enthesopathy, and spasticity. Although research of dry needling for these conditions is still in its
infancy, there is enough evidence to support adding new chapters to this book (Chapters 3 and 4).
In addition, we have updated all other chapters with recent, up-to-date research and streamlined
the clinical chapters with new colour illustrations. We made an exception for Chapter 13, authored
by the late Dr. Peter Baldry (1920–2016). Baldry, who at one time was president of the British
Medical Acupuncture Society, had a distinguished medical career that started well before the
introduction of penicillin. At a time when most physicians would consider slowing down, Baldry
started practicing acupuncture and trigger point dry needling, culminating in the publication of
several textbooks and articles about superficial dry needling approach. In memory of Dr. Baldry, we
included his original chapter in this volume.
As with the first edition, the ultimate objective of a clinical textbook is to contribute to developing
optimal treatment approaches to benefit our patients. Dry needling is effective for reducing acute
and chronic pain and improving motor performance, range of motion, and strength. We hope that
the research on underlying mechanisms and clinical outcomes will continue in the years ahead.
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Acknowledgements
A book on the current status of dry needling is dependent on the contributions of the authors. We
would like to thank José L. Arias-Buría, Peter Baldry, Betty T.M. Beersma, Carel Bron, Cory B.
Choma, Li-Wei Chou, Mike Cummings, Ana Isabel-de-la-Llave-Rincón, Michelle Finnegan, Jo L.M.
Franssen, Zhonghua Fu, Javier González Iglesias, Steven R. Goodman, Blair Green, Christian
Gröbli, Orlando Mayoral-del-Moral, Johnson McEvoy, Ricardo Ortega-Santiago, María Palacios-
Ceña, Jaime Salom Moreno, Bárbara Torres-Chica, and María Torres-Lacomba for taking the time to
share their experiences and insights.
We would also like to acknowledge the team at Elsevier, especially Serena Castelnovo and Poppy
Garraway Smith (Content Strategist), Kamatchi Madhavan (Senior Project Manager), and Veronika
Watkins (Content Development Specialist). We appreciate their patience, persistence,
professionalism, and encouragement throughout the entire process of producing this second edition
of the book.
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