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3 superficial dry needling


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superficial dry needling

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3 superficial dry needling

  1. 1. DR. SUBHANJAN DAS, PT +91 8967549104 Dry Needling Instructor MPT (Musculoskeletal & Sports) Assoc. Prof., BIMLS, Burdwan
  2. 2. Also in the series       needling   
  3. 3. 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
  4. 4. SDN 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
  5. 5. Rationale  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.
  6. 6. Development  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.
  7. 7. 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
  8. 8. strong 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 The needle should be withdrawn within seconds of insertion.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 role.
  9. 9. Average responders They need stimulation of seconds to about a minutes to get optimal needling effect
  10. 10. Weak responders  They need prolonged needling to achieve effects.
  11. 11. When to use SDN  When 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! 