Dry Needling Relieves Headache Pain & Tension

Therapydia Pain Relief Dry Needling Treatment

Many of us know that sitting and having good posture have become a part of our daily lives. Sitting in the same static position on a daily basis can cause a lot of problems with your posture that can eventually cause pain in unexpected locations. Headaches can be caused by issues that aren’t actually in your head. A cervicogenic headache is caused by shortening of muscles in and around your neck and at the base of the skull. Tight muscles can develop painful knots called trigger points and these trigger points can refer pain up from your neck to different parts of your head. Dry needling comes into play as a method of treatment for headaches by releasing tension in those tightened neck muscles and trigger points. Once you loosen those chronically tense neck muscles, you’ll be able to work on getting out of your poor posture and movement habits.

The Tension Around Your Head

Dry Needling Treatment Headache

This type of tightness in your neck muscles usually happens because of incorrect posture patterns. Many of us tend to hold a lot of tension up around the shoulder and neck muscles. This could be due to a lot of different aspects of our daily lives. Tension could result from:

• General stress and muscle fatigue
• Overall poor posture
• Constantly sitting at poorly designed work stations
• Carrying heavy items
• Using a shoulder strap for heavy bag
• Prolonged sitting in car seats while driving

Once you have that shortening of the muscles, your neck shifts into a forward head posture. The pulling at the base of the skull and in the neck is what causes the pain to extend up and around your head. The pain can also refer to different places around your head, like behind your eyes and around your temples. Taking painkillers like NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) will help with pain levels, but they won’t ultimately solve the source of the issue. The goal with trigger point dry needling treatment is to release tension in those muscles, restore muscle length, and ultimately decrease pain.

Treating Your Triggers

Dry needling acts as an effective treatment option because it allows tension to be released from the muscles in your neck. Since certain types of tension headaches are caused by muscular issues, they can be solved by directly treating those restrictions. A certified physical therapist can palpate the base of your skull, neck, and upper spine to look for knots in the muscle called active trigger points. Trigger points are tight areas of your muscle that are usually caused by trauma or repeated strain. Once the needle makes contact with those trigger points, they’ll cause a twitch response, or a small contraction. Contact with the needle causes an actual chemical change inside the muscle that releases tension, increases blood flow, and heals the issue. You’ll be getting rid of the trigger points that are causing tightness in your neck while also solving the source of your headaches.

Moving Back Into Alignment

Once those muscles are released, you’re also giving your body the chance to start moving back into correct spinal alignment. Extended periods of sitting or poor postural habits in general might have thrown all the muscles in your neck and upper back out of sync. Some may be too tight and others too stretched out and lengthened. After needling, you’ll able to bring the muscles along your upper spine into their proper ranges of motion. You’ll be able to move your head and shoulders back into the positions they’re supposed to be in. Without treating the restrictions around our neck and upper spine, you won’t be able to improve your posture.

Healing The Source Of Your Headaches

Using dry needling as a treatment method for muscular-based headaches will release the tension at the source of the pain. The goal with dry needling is to decrease the intensity as well as the frequency of your headaches. For example, if you’re used to experiencing a headache for the entire day you might start having a headache for only a few hours a day. After a few more sessions, you may not feel any pain around your head at all. Once you have the necessary range of motion you need around your neck and upper spine, you’ll be preventing any future headaches from happening. Consider dry needling for your headaches by getting rid of them in the present as well as healing the muscles to prevent the issue from happening in the future. If you have any questions about whether or not the headaches you’re experiencing can be treated with dry needling, call us at Therapydia Denver.

Summer Knee Pain? Trigger Point Dry Needling May Be The Solution.

run assessment denver

Summer in Colorado brings warmer temperatures, longer days and inevitably more time spent outdoors. Many Coloradans choose to take advantage of summer by hiking or running on our vast network of urban and mountain trails. Oftentimes, this increase in miles traveled on our feet can lead to pain in and around the knee, specifically the kneecap. This pain is technically termed patellofemoral pain syndrome, but is commonly referred to as hiker’s or runner’s knee.

How Do I Know If I Have Hiker’s Or Runner’s Knee?

Another sign that you may be at risk for developing hiker’s or runner’s knee is a knock kneed (valgus) position during activities like squatting or walking up or down stairs. This position makes it more likely that your knee will become irritated or painful. The hallmark sign of hiker’s or runner’s knee is pain around or under the kneecap. This pain is usually worsened with squatting and walking up or down stairs or hills.

runner knee signs

 

Image credit: http://what-when-how.com/

What Is Patellofemoral Pain Syndrome?

Patellofemoral pain refers to pain arising from excessive or faulty contact between the kneecap (patella) and the bottom portion of the thigh bone (femur). The patella lies in a groove between two rounded portions of the bottom of the femur.  It is essentially like the patella is sitting in a valley between two hills.patella pain running

During weight bearing activity where the knee is bending and straightening (such as walking, hiking or running), the patella glides up and down in the valley between the hills. If the patella does not glide perfectly in the valley, it may grind awkwardly on one or both of the hills.  This grinding causes irritation, popping, pain and sometimes swelling.

What Causes Patellofemoral Pain Syndrome?

The patella is a sesamoid bone, meaning that it is suspended between two tendons rather than being attached to another bone by a ligament. The top portion of the patella is connected to the quadriceps tendon, which then attaches to the quadriceps muscle group. The bottom portion of the patella is connected to the patellar tendon, which then attaches to the shin bone (tibia).  This unique arrangement allows the patella to be pulled one way or another based on variability in muscle strength and flexibility.

patellofemoral dry needling

Image credit: http://physioworks.com.au/

The most common strength/flexibility issue leading to patellofemoral pain involves weakness in muscles on the inside of the thigh (vastus medialis obliquus) coupled with tightness in the muscles and tendons on the outside of the thigh (vastus lateralis, iliotibial band).  This weakness on the inside and tightness on the outside pulls the patella to the outside, causing it to grind up on the lateral hill rather than gliding perfectly in the valley.

Another common flexibility issue leading to patellofemoral pain involves tightness in the muscles on the back side of the thigh, also known as the hamstrings. Tightness in the hamstring group pulls the shin bone backwards, thus increasing the amount of force with which the patella is sitting in the valley. This increased force can lead to grinding and irritation between the patella and the femur, even if it is gliding in the correct portion of the valley.

How Can Trigger Point Dry Needling help?

Trigger Point Dry Needling (also known as functional dry needling or intramuscular manual therapy) involves inserting a tiny filiform needle into a taut band of muscle tissue, also known as a trigger point.  This causes the muscle to momentarily cramp and eventually release.  This treatment option is extremely effective in releasing muscle tension and restoring normal flexibility and function rapidly.

When addressing patellofemoral pain, releasing muscle tension and restoring normal muscle flexibility can decrease the likelihood that the patella will be pulled out of the valley and cause grinding, irritation and pain.  Releasing tension in the hamstring group can help decrease the amount of force with which the patella is pushing into the valley.  Coupled with specific strengthening and stretching exercise as prescribed by your Physical Therapist at Therapydia, Trigger Point Dry Needling is an effective tool in combating knee pain in hikers and runners.

Sciatica: What Is It and How Can Physical Therapy Fix It?

Medical man with back ache

Sciatica is one of the most common diagnoses that we see in physical therapy.  But what exactly is sciatica and how do PTs treat this complex diagnosis?  Well the simple answer is the treatment is all dictated by the source.

Generally, sciatica is a term that is commonly used to describe pain, weakness, numbness, or tingling that radiates down the back of the leg. Typically, the symptoms follow the distribution of the sciatic nerve but there can be some confusion as to the source of the pain especially when the patients symptoms are found to be referred.  Our job as PTs is to determine what the source of the nerve irritation or referral origin is and treat it accordingly.  This can often be accomplished with a thorough musculoskeletal exam and typically without the need for costly medical imaging.   Below are the most common causes of sciatica seen in PT and how we typically treat them.

DISC HERNIATION

 

HERNIA OF THE DISC - SLIPPED DISCThe most common source of sciatica is pressure on the sciatic nerve from a herniation or protrusion of a spinal disc.  This pressure on the nerve can create an irritation and inflammatory response causing symptoms to radiate down the leg following the path of the nerve that is compressed.

What can physical therapy do to help patients with sciatica caused by a disc herniation?

Studies have shown that patients respond well to repetitive lumbar range of motion in improving sciatica symptoms related to lumbar disc herniation.  Typically the direction that most patients report relief of their symptoms is lumbar extension.  However, a thorough physical therapy assessment will help decide a patient’s specific “directional preference”.

Core stabilization exercises in conjunction with lumbar range of motion are also effective at reducing sciatica symptoms.  PTs tend to focus on strengthening the transversus abdominis and gluteal muscles in both static and dynamic activities.

Patient education is probably the most important component of the rehab of disc herniation.  Patients are educated on proper sitting and standing postures as well as proper body mechanics with lifting activities to avoid causing further disc herniation.

STENOSIS

 Denver Physical Therapy Stenosis

Narrowing of the space where the spinal cord or nerve roots exit the spinal canal is called stenosis.  If the space is narrowed, that can create pressure on the cord or the nerves causing pain to radiate down the leg.

Stenosis is typically seen in a condition called degenerative disc disease.  Our discs are located between the bony vertebrates and over time they can start to lose some of their height.  This loss of height causes the narrowing of space seen in stenosis.

Another cause of stenosis is tiny little bone spurs called osteophytes that can form in the spinal cord or nerve root space.

What can physical therapy do to help patients with sciatica caused by stenosis?

Our goal in PT is typically to help improve ROM in the lumbar spine to help open up the narrowed space.  Patients with stenosis often respond well to lumbar flexion or bending exercises, which is in contrast to the lumbar extension exercises often seen in disc herniation.  However, a thorough physical therapy exam will help determine the appropriate stretches/range of motion exercises.

As with disc herniation, core stabilization and posture/movement retraining are important for patients with sciatica caused by stenosis.

Functional dry needling (i.e. Trigger point dry needling) is also very effective for patients with lumbar stenosis.  Photo Oct 27, 9 29 32 AMBy using tiny, hair thin needles, we can quickly decrease the muscle tightness of spinal muscles, resulting in decreased compression of the lumbar vertebrae.  We will discuss dry needling more in the last section

 

PIRIFORMIS SYNDROME

Deep in your buttock/gluts is a muscle that runs diagonally from the outside of your hip to the lowest part of your spine.  This muscle, called the piriformis, can get short and tight or even be in spasm. In 85% of the population, the sciatic nerve runs just beneath the piriformis and in the other 15% it runs through the muscle.  The sciatic nerve can become compressed and irritated when the piriformis is taught or in spasm creating symptoms of sciatica down the back of the leg.

piriformis_anatomy02Image credit: http://www.methodistorthopedics.com/piriformis-syndrome

What can physical therapy do to help patients with sciatica caused by piriformis syndrome?

Typically, a physical therapist will prescribe a thorough home exercise program that includes stretches for the piriformis, hamstrings, and glute muscles (see linked video for example of a piriformis stretch).

Sciatic nerve glides/flossing can be effective at getting the sciatic nerve moving again if it is trapped by the piriformis, especially in conjunction with the stretches above (see linked video for example of a sciatic nerve glide).

A common theme with all of the causes of sciatica is core stabilization.  Core and glute strengthening exercises will help to reduce the demands put on the piriformis muscle with daily and recreational activities (see linked video for an example of a core exercise).

Trigger point dry needling has also been found to be very effective at quickly reducing the tension of the piriformis.

 

TRIGGER POINT REFERRAL PAIN

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Image credit:  http://www.partnersinhealthclinic.com/conditions-treated-with-tdn

Trigger points are tender knots in skeletal muscles that often cause radiating or referral pain.  In the case of sciatica, trigger points in the gluteus minimus, gluteus medius, and piriformis muscles are common sources of radiating pain into the back of the leg.  Trigger points are located in almost all muscles in the body but usually lay dormant without referring pain.  Dysfunction of movement patterns, compensation for weaknesses, or postural deficits, among many other things, can cause the trigger points in the dysfunctional muscle to become active and painful.

What can physical therapy do to help patients with sciatica caused by trigger points?

Physical therapists can assess movement patterns to determine if the trigger point is the source of sciatica symptoms and correct any movement dysfunction that they find.

Joint mobilization, massage therapy, and myofascial release are common techniques to release or inhibit an active trigger point.

Trigger point dry needling (also known as TDN, functional dry needling or intramuscular manual therapy) is becoming a very popular treatment for a variety of musculoskeletal issues but especially sciatica.  As mentioned above, TDN involves the insertion of a tiny filiform needle into the trigger point.  When the needle reaches the trigger point it creates a twitch response which feels like a cramp.  The muscle relaxes and the trigger point becomes inhibited, alleviating the symptoms of sciatica.