Dry needling is a minimally invasive procedure in which an acupuncture needle is inserted directly into a muscle (known as a myofascial trigger point – MTrP). An MTrP is a highly localized, hyperirritable spot in a palpable, taut band of skeletal muscle fibers. Essentially an MTrP is a knot within a muscle. 74-85% of patients with pain present with MTrPs in their area of discomfort.
Dry needling an MTrP is most effective when local ‘twitch responses’ are elicited, probably because of rapid depolarization of the involved muscle fibers, which manifests as local twitches. Once the needle hits a tight part of the muscle, the patients’ muscle can twitch. After the muscle has finished twitching, the spontaneous electrical activity subsides and the pain and dysfunction decrease dramatically.
Dry needling breaks up muscle tightness, tension, knots and scar tissue. It helps in reducing muscle spasms, pain and muscle sensitivity. More specifically, dry needling has been proven to be very effective for low back pain. It provides pain relief and functional improvement in those with chronic low back pain and lumbar myofascial pain. Evidence suggests the improvements are further enhanced when the muscle is stretched afterwards. Needling deep into the muscle has been shown to be more effective than superficial needling. Howver, over the areas of the lungs or large blood vessels, superficial dry needling has been shown to be more appropriate and just as effective. Dry needling is a very safe method of treating muscular injuries and pains, and adverse side effects post treatment are very rare.
If you are suffering with muscular pain and tightness, please do not hesitate to contact us to book a consultation
Yours in Health,
The Lawlor Clinic Portlaoise
Chiropractic | Active Release Techniques (ART®) | Functional Range Conditioning (FRC®)
Plantar Fasciitis (PF) can be quite a debilitating disorder. It is commonly described as having pain under the heel of the foot or along the arch of the foot. It is a progressive disorder, where the first few steps in the morning are painful, along with barefoot walking, or pain wearing flat shoes. Prolonged standing, walking or running can aggravated the pain. Many different treatment options have been proven to be effective in treating PF, such as deep tissue work, stretching and manual therapy. But, are there any additional therapies that are effective at treating PF, for example, if the hands-on approach is not yielding results to your liking?
At the Lawlor Clinic, we utilise Class 4 Laser Therapy for a variety of conditions, including PF. But, is it any good? Are there positive results with this approach? Or is it all a load of nonsense? Let’s see what the evidence says.
Class 4 Laser Therapy
With laser therapy, a light beam is placed on the injured area in an effort to affect cellular metabolism, protein synthesis, wound healing and immune response. The idea is that this will fight the inflammation in the fascia, reduce heel pain, and increase recovery time. 2 papers have evaluated the effectiveness of Class 4 Laser Therapy on chronic PF, and have a strong quality of evidence as they appear on the Cochrane Database of Research.
Macias, 2015
Kiritisi, 2010
Participants
69
25
Laser Treatment
X2/week for 3 weeks
X1/week for 6 weeks
Follow Ups
Before, 1week, 2weeks, 3weeks, 6weeks, 8weeks
Before and at 6weeks
Results – Plantar thickness
DNA
A difference in plantar thickness, but not statistically significant (not meaningful)
Results – Pain
Statistically significant improvement (p<0.001)
Statistically significant improvement (p=0.001)
These two studies demonstrate that after 6 sessions of Laser Therapy, the PF pain had significantly reduced when compared to placebos. This shows that laser is effective in treating PF, but it is important to explain to patients that research suggest that the most effective treatment approach is 6 treatments either x2/week for 3weeks or x1/week for 6weeks and then the patient can make up their mind which they would rather.
Comparing Laser to Extracorporal Shock Wave Therapy (ESWT)
The idea behind ESWT is similar to LLLT. In ESWT, a probe is placed on injured area and shockwaves are pulsed in through the skin to stimulate angiogenesis (new blood vessels) and neurogenesis (new nerve cells). In theory, these aspects stimulate wound healing mechanisms. Again, 2 high quality papers compared the use of LLLT vs ESWT:
Cinar, 2013
Suleymanoglu, 2014
Participants
55
81
Treatment
X3/week for 3weeks of either ESWT / Laser
X3/week for 3weeks (ESWT)
X3/week for 4weeks (Laser)
Both given stretches for 3 months
Follow Up
Before and at 3 weeks
Before, after 1st session, after 3 months
Results – Plantar Thickness
DNA
Reduction in plantar thickness, more significant reduction in ESWT
Results – Pain
Statistically significant reduction in pain with Laser, not in ESWT
Statistically significant reduction in pain with ESWT, not in Laser
The data above suggests there is no difference between using Laser or ESWT for treating PF. This is because of the conflicting evidence above.
In summary, the evidence demonstrates that Laser (once completed for 6 sessions between 3-6weeks) is very effective in reducing pain levels in those with chronic PF. If you are suffering with PF, or any foot pain, please do not hesitate to contact us today
