Also in the series
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
SDN 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
A 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.
With 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 present
The needle is kept inserted for 30 seconds to 3
minutes, depending on the type of responders.
Type of responders
Depending on the responsiveness of the patient to
needling, they are divided into 3 types:
1. strong responders
2. Average responders
3. Weak responders
A 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 The needle should be withdrawn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
They need stimulation of seconds to about a minutes to
get optimal needling effect
They need prolonged needling to achieve effects.
When to use SDN
When treating pain, when release of opioids are
primary therapeutic goal.
When treating areas with sensitive underlying
When dermatomes and myotomes coincide.
When in doubt about safety!