SuperficialDry Needling

DR. SUBHANJAN DAS, PTSubhanjan_82@yahoo.com

+91 8967549104Dry Needling Instructor

MPT (Musculoskeletal & Sports)Assoc. Prof., BIMLS, Burdwan

Also in the serieshttp://www.slideshare.net/SubhanjanDas/introduction-to-dry-nee

dling

http://www.slideshare.net/SubhanjanDas/2-brief-hisory-of-needling

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Although it is certainly essential to locate each TrP accurately, experience has led me to believe that it is not necessary to employ deep needling but easier, safer and just as effective to insert the needle into the superficial tissues overlying a TrP

-Peter Baldry

SDNSDN has been started by Peter Baldry in

1980’s.Baldry was treating a trigger point in the

scalaneus anterior muscle when to prevent accidental damage to pleura he inserted the needle just a few millimeters into the skin.

He found this to be as effective as DDN

RationaleA lot of effects of dry needling is achieved via

stimulation of A delta nerve ending.Majority of the A-d sensory afferents are

present in the skin and just beneath it.

DevelopmentWith the success of scalanae Baldry

developed a system of SDN for trigger points all over the body, even with the deep muscles.

In SDN the needle is inserted in the skin overlying the trigger points to a depth of 5-10mm

LTR phenomenon will not be presentThe needle is kept inserted for 30 seconds to

3 minutes, depending on the type of responders.

Type of respondersDepending on the responsiveness of the

patient to needling, they are divided into 3 types:

1. strong responders2. Average responders3. Weak responders

strong respondersA strong responder will achieve needling

effects with minimal stimulation. The needle should be withdrawn within seconds of insertion.

Overstimulation will increase patients symptoms.

They constitute about 10% of all individuals.This may be related to the phenomenon of

opioid induced hyperalgesia. Higher levels of CCK may play a role.

Average respondersThey need stimulation of seconds to about a

minutes to get optimal needling effect

Weak respondersThey need prolonged needling to achieve

effects.

When to use SDNWhen treating pain, when release of opioids

are primary therapeutic goal.When treating areas with sensitive

underlying structures.When dermatomes and myotomes coincide.When in doubt about safety!