Download Treat Your Neck and Back Pain with “Pin

Treat Your Neck and Back Pain with “Pin-point” Accuracy
Gabe Smith, PT, DPT, OCS
Bluegrass Outpatient Center
Neck and low back pain seem to be inevitable. It’s widely stated that at least 80% of us will
suffer back or neck pain at least once in our lives. For many, neck and low back pain can be
chronic and lead to significant loss of function and even disability. Americans with neck and low
back pain spend tens of billions of dollars per year on treatment with mixed results, at best.
Commonly neck and back pain sufferers complain of having “knots” in their muscles known in
the medical community as trigger points. A trigger point is a nodule within a tight band of
muscle that is tender to the touch. Trigger points can produce localized pain within the muscle,
but can also cause pain in other parts of the body. They are usually found in those who have
suffered traumatic injury such as whiplash, but also can contribute to everyday aches and pains
due to poor posture, improper nutrition, lack of exercise and poor sleep habits. If you have
active trigger points, you are well aware of the pain they can cause. You have likely tried several
different treatments such as heat, ice, massage, stretching, and for some, injections and pain
medication, which may or may not help.
Over the last few years a lot of research has been done on the treatment of trigger point pain,
and now an emerging body of evidence supports a safe, minimally-invasive Intramuscular
Manual Therapy treatment referred to in the medical community as Trigger Point Dry Needling
(TDN). In this technique, a specially-trained physical therapist briefly inserts a very small needle,
similar to those used in acupuncture, into the trigger point. The introduction of the needle
commonly produces a muscle twitch. This twitch response is very closely associated with a
normalization of muscle tone, a reduction in pain, muscle tension and improvement in muscle
function. This treatment is best used in conjunction with therapeutic exercise and other manual
therapy techniques, such as soft tissue and joint mobilization/manipulation. TDN as a standalone treatment can provide temporary pain relief; however, the pain will probably return if
contributing factors such as muscle weakness, joint stiffness, and poor posture, nutrition and
sleep habits are not addressed.
Two very common questions are “What does it feel like?” and “Does it hurt?” For most
patients, TDN is very comfortable. Rarely does the patient actually feel a pin prick. When the
needle reaches the muscle it is common for the patient to feel a mild, temporary achiness,
often accompanied by an involuntary muscle twitch. Following the treatment, significant pain
relief can be expected along with improved movement. Muscle fatigue and mild soreness, or an
“overworked” sensation can occur. These sensations are temporary and the patient can expect
to have continued pain relief, especially when home exercises are performed as prescribed by
the physical therapist. Frequency of treatment varies depending upon the needs of the patient,
but treatments are usually no more than one to two times a week for no more than four weeks.
The goal is to gain enough pain relief and improved muscle function that the patient can
tolerate performing exercises and activities that allow them to perform their daily activities
without being limited by pain.
TDN is a safe and effective treatment for trigger point pain. Its results are best maintained
when accompanied by specific therapeutic exercises and other manual therapies. The therapy
is very comfortable and can quickly result in dramatic reductions in pain, allowing you to
function more normally. If you are suffering from neck or back pain and suspect trigger points
may be a contributing factor, contact Bluegrass Outpatient Center at (270) 796-6800 for more
information about how trigger point dry needling treatments can help. TDN is also available
through Rehabilitation Services at The Medical Center at Franklin and The Medical Center at
Scottsville.
About the author: Gabe Smith, PT, DPT, OCS is a physical therapist with Bluegrass Outpatient
Center in Bowling Green, KY. He specializes in treating those who suffer from back and neck
pain as well as other musculoskeletal disorders and uses a hands-on treatment approach called
manual therapy, which includes Intramuscular Manual Therapy (Trigger Point Dry Needling) for
the treatment of trigger points. He earned his Master’s degree in physical therapy from
University of Kentucky in 2003. He completed his Doctorate of Physical Therapy degree (DPT) in
2007. He is board certified as an Orthopedic Clinical Specialist (OCS) by the American Physical
Therapy Association.