Myofascial infiltrations and dry needling

Myofascial infiltrations

Myofascial infiltrations consist of small subdermal and intramuscular injections directly into the painful area, to treat musculoskeletal syndromes.

Pain may arise from excessive release of inflammatory substances and functional abnormalities of muscle fibres: infiltrations are used to deactivate these areas.

Dry needling

Dry needling, or dry puncture, uses very thin needles in myofascial tissue to treat muscular pain, reduced movement and contractures.

Unlike infiltrations, it does not inject substances: it is completely free from possible drug-related side effects and can also be performed in cases of allergies or intolerances. A suitably manipulated needle acts on the localised contracture and improves mobility and pain.

When they may be used

The main indication for both techniques is myofascial syndrome, which may present with continuous muscle pain, contractures, functional limitations or tingling.

Trigger Points can be identified during the consultation by palpation or gentle pressure.

• Tension-type headaches, migraine and neuralgias.
• Low back pain, neck pain and hip pain.
• Fibromyalgia syndrome and cervical osteoarthritis.
• Sacroiliac pain, shoulder periarthritis and nocturnal cramps.

Choosing the technique and substances

For infiltrations, I use lidocaine most often, at very low concentrations and volumes, because of its safety and efficacy.

Dry needling does not use medicines. The choice of one technique or a combination depends on medical history and overall assessment.

Precautions and possible effects

Lidocaine allergy is an absolute contraindication to myofascial infiltrations; in some cases dry needling may be assessed.

Some heart conditions, infection of the area, clotting disorders and blood diseases may contraindicate one or both techniques.

• Infiltrations may be slightly painful, and the medication may cause burning for a few seconds.
• Dry needling is not painful, although it may cause slight discomfort that disappears after a few seconds.
• Small bruises may occur after treatment and disappear within a couple of days.