Category: Complementary and Alternative Therapies
Injury Type: Acute/Chronic
What is it?
Intra-muscular injection, or dry needling involve the insertion of fine acupuncture needles into myofascial trigger points, with the aim of deactivating trigger points. Trigger points are thought to be hyperirritable spots in skeletal muscle that are associated with 'knots' in tight bands of muscle fibers. The palpable nodules are said to be small contraction knots and a common cause of pain. Compression of a trigger point may elicit local tenderness, referred pain, or local twitch response. Dry needling uses western based anatomy and physiology to select the myofascial trigger points found in muscles throughout the body. Many of these points correspond with those used in Traditional Chinese Medicine during acupuncture. Commonly following whiplash, the muscles at the back of the neck become shortened, tight and painful, and these muscles may form the target of intra-muscular injection.
How does it work?
Trigger points are painful on compression and can give rise to characteristic referred pain/tenderness, motor dysfunction and "autonomic" responses; these can include temperature and skin changes over the site. Dry needling of the 'shortened' muscle band may cause an immediate relaxation in the muscle. A sense of release and increased range of motion may also be experienced by the patient.
Is it effective?
There is only one study examining the effect of intra-muscular injection on whiplash. In this study subjects reported an improvement following a course of dry needling. Unfortunately, the study did not compare dry needling with no treatment or placebo (dummy) treatment.
Are there any disadvantages?
There should be few side effects when practiced by a qualified health practitioner. However, you may experience some discomfort associated with the insertion of the needle, and/or movement of the needle within the muscle. If it is painful you should inform the practitioner.
Where do you get it?
Acupuncturists, Physiotherapists and other health professionals who have all undertaken courses in dry needling can provide intra-muscular injection. They can be found in the Yellow Pages.
The effects of dry needling have not been fully evaluated and hence cannot be recommended for whiplash. Further research is needed.
- Gunn, CC, Byrne, D, Lam, A, Leung, MK, McBrinn, J, Nixon, A & Wong, K 2001, 'Treating whiplash associated disorders', Journal of Musculoskeletal Pain, vol. 9, pp. 68-89.
- Pelso, P, Gross, A, Haines, T, Trinh, K, Goldsmith, CH, Burnie, S, Cervical Overview Group 2007, 'Medicinal and injection therapies for mechanical neck disorders', Cochrane Database of Systematic Reviews, Issue 3, Art.No.: CD000319. DOI:10.1002/14651858.CD000319.pub4.