Acupuncture is a therapeutic method used to encourage natural healing, reduce or relieve pain and improve function of affected areas of the body. Acupuncture involves the insertion of very fine needles through the skin and tissues at specific points on the body. "Classical" acupuncture aims to balance the energy and blood in the body in order to keep it functional and healthy. "Anatomical" acupuncture looks at the anatomy, physiology and pathophysiology of trigger points and areas of "chi" that will help improve a persons function. During acupuncture, electro-acupuncture may be used where there is a stimulation of the inserted needles with gentle electrical impulses. Acupuncture stimulates the body to produce an increased amount of endorphins. Acupuncture can be used in conjunction with physiotherapy for neurological and muscular disorders, headaches, neck and back pain, neuralgia, frozen shoulder, tennis elbow, tendinitis, sciatica, arthritis, and chronic myofascial pain syndromes.
Dry needling is a method for managing chronic myofascial pain. The key to treatment is to release muscle spasm and muscle shortening by needling painful trigger points in the muscle using various needling techniques. "Dry needling pierces the muscle and disrupts the cell membrane of individual muscle fibers mechanically discharging a brief outburst of injury potentials. Needling also induces a sympatholytic effect releasing vasoconstrictive and platelet derived growth factors which induces deoxyribonucleic acid syntheses and stimulates collagen formation and the healing process. The needling creates the body's own source of bio energy through the injury to promote healing." - Cynthia Gokavi. Essentially, dry needling will release tender trigger points and spasms thereby giving length to the muscle, thus relieving pressure on the nerves, improving mobility, and reducing pain to re-establish normal function. The Gokavi Transverse Technique (GTT) is a technique whereby needles are inserted in a transverse direction in a closed circuit and stimulated electrically at high frequencies, causing analgesia and relaxation to the muscle. This procedure enables the muscle to be lifted and the dry needling done in a transverse direction through the entire thickness of the muscle using a plunger or needle holder. Dry needling is most effective for patients with chronic pain that have tried a variety of treatments in the past and have had minimal lasting effect. If this technique is appropriate for the patient, they will have immediate results in their first treatment session. A patient will usually express a 50% improvement in the first session and should have close to maximal function after their 3rd treatment. When a patient receives dry needling, they will receive a full physiotherapy assessment as well as other physiotherapy treatments such as manual therapy, stretching and exercise. This will help maintain their improvement of physical function as well as prevent reoccurrence of the same symptoms.