Dry puncture in physiotherapy

Laura Garcia

5 September, 2019

Dry puncture allows better results in a shorter period of time and is very effective in treating some very specific injuries, making the recovery process more active, fast and functional.

Dry puncture is a physiotherapy technique that is used to treat myofascial pain syndrome, through the mechanical stimulation of a needle.

Myofascial pain syndrome
Myofascial Pain Syndrome is a set of Sensory, motor and autonomic symptoms caused by a trigger point, which is a hyper-responsive muscle area, associated with a hypersensitive palpable nodule within a tense band. The tense band is what we usually know as muscle contracture It is a painful area of ​​compression, which causes pain referred to, hypersensitivity to pressure and motor dysfunction.

To identify one trigger point, we have to deal with the following scenarios:

• Locate a tense palpable band (contraction zone).
• There is local pain at the pressure of a nodule in the tense band, causing a local spasm response (involuntary muscle contraction that we will try to eliminate with puncture).
• Recognition by the patient of his usual pain when pressing on the sensitive nodule.
• Painful limitation of the amplitude of the movement when stretching the muscle. This musculature is weakened but does not present atrophy.

A trigger point causes it pain referred, which is a pain that radiates to other areas related to muscle in particular. Each one of them has a specific pain pattern referred to. In all this area pain and disesthesia appear. Some examples of this type of pain could be one Tensional headache, tingling or the same muscle weakness.

Dry puncture is a physiotherapy technique that is used to treat myofascial pain syndrome, through the mechanical stimulation of a needle.

The myofascial pain syndrome it can be treated with analytical stretching, or combining them with application of sprays or with facilitation techniques. It can also be treated with compression, massotherapy or inhibition techniques, or by the techniques of invasive physiotherapy: dry puncture.


Treatment with dry puncture
We will use the dry puncture when we have used the aforementioned resources and there is not a great improvement, or when the muscle to treat is very deep and not accessible with the manual therapy.
It is a technique much more effective than the others and obtains immediate results, which allows us to tackle the muscle directly. Therefore, it is indicated to treat any musculoskeletal problem that curses with muscular limitations or discomforts, as long as it is caused by a trigger point and manifested by local or referred pain.

They exist two types of dry puncture: the superficial, which leaving the needle a few minutes superficially causes the local sensibility to disappear, and the deep, with which you work intramuscularly, looking for local spasm responses. What it does is to eliminate dysfunctional motor plates so that they regenerate again in a healthy way.

You always have to make one good post puncture treatment, doing a good hemostasis, applying cold spray, stretching the muscles and doing local amalgamation. It is also necessary to make free active movements throughout the joint route to activate the musculature worked and its antagonists.

It's very important communication with the patient, since according to what is noted it will guide the practice. Before performing the technique, we need to inform you about what we will do and post puncture pain, because it is normal to experience local pain in the muscles worked, which can last from a few hours until two days after the session. It is a normal and controlled pain caused by the breakage of the motor plate (neuromuscular joint).
Also, it is necessary to know the possible risks in the application of this technique, which are avoided with good practice, given by the correct training of the physiotherapist, who must be registered in the registry of dry puncture of the College of Physiotherapists .
This information will be recorded in a document: informed consent, signed by both the patient and the physiotherapist.


Contraindications
It is not advisable to apply the technique to people with needle phobia, people with problems of coagulation, uncontrolled hypothyroidism, allergy to metals (especially nickel), pregnant women, children (parents' consent) and people with breast implants or prosthesis.


In conclusion, we will say that this technique allows for better results in a shorter period of time and is very effective in the treatment of some very specific injuries, making the recovery process more active, fast and functional. Everything in physiotherapy can always find an alternative.

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the author

Laura Garcia

Physiotherapist

I'm a physiotherapist specialized in the field of neurology.

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