Ultrasound Guided Dry Needling

Ultrasound Guided Dry Needling (USGDN) is a specific treatment for myofascial pain syndromes (MPS) wherein a needle is inserted into painful sites in the muscle called myofascial trigger point (MTrP). MTrP is defined as ‘a hyperirritable spot,’ within a painful taut band (TB) in a skeletal muscle. So, in any pain condition multiple fine needles (37 Gauge) are inserted into all the painful areas while visualising the needle under sonography and looking at the muscle architecture, thickness and reaction to needle insertion.

MTrPs exhibit a unique local twitch response (LTR) or a “jump” on needle insertion mediated by a spinal reflex. LTR can be visualized with ultrasound. Active MTrPs are spontaneously painful, refer pain and paresthesia to distal sites. Latent MTrPs are painful only on palpation. Both active and latent MTrPs cause muscle stiffness, weakness and restricted range of motion (ROM). USGDN causes immediate, complete pain relief by a physical ‘needle effect’ without any injection. USGDN also causes micro bleeding in the affected muscles. This brings in lot of growth factors to that muscle and causes regeneration and healing.

Ultrasound visualization revolutionizes Dry Needling into a more extensive as well as comprehensive version called USGDN which addresses the interrelated functioning of the various structures in the body that work as parts of the whole and when one part suffers it appears to involve all the others. USGDN targets not only the pain but also the disability resulting from the structural impairment that mechanically alter the function in all coworking muscles. This makes USGDN a specific treatment option for all chronic pains like neuropathic pains, cancer pains, back pains and arthritic pains all of which manifest with MPS.

Indications:

USGDN is a part of the treatment regime for almost all pain conditions presenting to our clinic. Because we believe that every pain has a muscular component which needs to be addressed using USGDN.

All interventions like Epidural steroid injection, Pulsed radiofrequency or BOTOX™ are followed by USGDN to achieve complete and sustainable pain relief and disability correction.

Procedure:

USGDN is carried out as multiple sessions, the number of which depends on the condition being treated.
The patient spends 2-2.5 hours every time he comes for the procedure.
It is performed 1-2 times/ week depending on severity of the pain.
When the patient arrives, Physiotherapy exercises as advised are explained, local anaesthetic cream is applied to the area which will receive the needles, physiotherapy modalities like ultrasound and TENS are applied. Needle insertion is performed under sonography guidance and left in place for 30 mins. After removal, Ice packing and manual therapy is performed.

Side effects:

Occasionally bruises can be seen after removal of needles and they may remain for 7-10 days and resolve spontaneously. They are not of any concern.
The USGDN of chest and abdomen is always performed under sonography guidance hence, puncturing of the pleura or peritoneum doesn’t occur.

Ultrasound Guided Dry Needling

Ultrasound Guided Dry Needling

Indications:

Procedure:

Side effects:

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