- pain
- reduced range of motion
- pain when stretching the muscle
- weakness
- pain when contracting the muscle
- Headaches (especially tension-type)
- Migraine
- Neuralgias (trigeminal, facial, sciatica, etc.)
- Low back pain (back pain)
- Cervical pain (neck pain)
- Fibromyalgia syndrome
- Cervical spine osteoarthritis
- Temporomandibular joint osteoarthritis
- Coxalgia (hip pain)
- Pain in the sacroiliac joint
- Lumbar spondylolisthesis
- Shoulder and scapulohumeral periarthritis
- Nocturnal cramps
- Nutritional factors (e.g., vitamin deficiencies, etc.)
- Endocrine and metabolic factors
- Psychological factors
- Sleep disturbances
- Postural habits
- Unsuitable chairs and seats
- Incorrect positions
- Repetitive movements
- Infection of the area to be treated
- Coagulation disorders
- Blood diseases
What are Myofascial Infiltrations and Dry Needling?
Myofascial infiltrations consist of making small subdermal and intramuscular injections directly into the painful area to treat disorders of the musculoskeletal system, such as muscular or connective tissue conditions.
The pain we feel is due to an excessive release of inflammatory substances and functional anomalies of muscle fibers: infiltrations serve precisely to “deactivate” these areas.
Dry needling, or “dry puncture“, is a technique based on the insertion of very thin needles (like those used in acupuncture) into the myofascial tissue to treat muscle pain, even when associated with limited movement and contractures.
Unlike infiltrations, it does not involve injecting substances. This makes it completely free from possible drug-related side effects and it can also be performed in cases of allergies or intolerances.
The goal of this technique is to stimulate the nervous system, muscle and connective tissue to release anti-inflammatory substances to promote muscle relaxation and healing.
When are they indicated?
The main indication for these two techniques is myofascial syndrome.
Myofascial syndrome includes several conditions that present mainly with continuous muscle pain and sometimes with contractures, functional limitations, or tingling sensations.
Myofascial syndrome is characterized by “Trigger Points“ or “Grilletto Points”: areas of greater or lesser hypersensitivity on a specific muscle or muscle fascia. During the visit they can be identified through palpation or slight pressure.
The symptoms that may suggest a myofascial syndrome are therefore:
It is often not easy to distinguish myofascial syndrome from other causes of pain, so a careful and thorough examination can identify the cause of your problem.
These two techniques can be used in case of:
Myofascial infiltrations and acupuncture
Already in the 1970s, the correspondence of more than 70% of Trigger Points with acupuncture points (Ronald Melzack) was identified, and in my experience combining the two techniques often leads to excellent results and problem resolution in just a few sessions.
What causes myofascial syndrome pain?
Myofascial syndrome, and therefore the presence of “Trigger points”, is due to a form of neuromuscular dysfunction that can arise from even a minor traumatic event (a muscle strain, a fall, etc.) but also from posture or incorrect movement that trigger a series of reactions such as inflammation and the release of hormones and neuromodulators in the muscle tissue that produce pain.
The frequency and duration of pain in a specific muscle or muscle group depend on various factors. For example:
A timely therapeutic plan is essential to prevent pain from progressing from an acute phase to a chronic one that can last for many months
Which drugs are used?
The drugs that have proven effective are local anesthetics which, in addition to their analgesic effect, can regulate the neuromuscular processes underlying pain.
The medication I use most frequently for infiltrations, given its safety and efficacy, is lidocaine at very low concentrations and volumes.
Dry needling instead does not involve the use of drugs; it is based exclusively on the action of a very thin needle which, when properly manipulated, acts on the localized contracture and improves both mobility and pain.
The choice of one of the two techniques, or a combination of both, always depends on the medical history and overall assessment of your condition
When is it not possible to perform myofascial infiltrations?
In myofascial infiltration lidocaine allergy is an absolute contraindication. In these cases, if I consider it appropriate for your specific case, dry needling can be used since it does not involve drugs and therefore does not pose an allergy risk.
Some heart diseases, such as severe bundle branch block, are also a contraindication.
There are also some situations that do not allow the performance of either technique, for example:
Do these treatments have side effects?
Infiltrations can be a bit painful depending on each person's pain threshold. To create minimal discomfort I always use the thinnest needles possible.
Even the injection of the medication can cause a burning sensation but it will only last a few seconds.
Dry needling is not painful; the very thin needle and manipulation technique may cause slight discomfort that disappears after a few seconds.
Small bruises may appear after the treatment and disappear in a couple of days.
Overall these treatments are very well tolerated
