In the exciting world of recovery and rehabilitation, we now have several recovery aids at our disposal. When used correctly, they may help to increase function, regain mobility, and improve quality of life. Knowing which ones to use to combat chronic and often debilitating conditions forms part of the decision-making process.
Myofascial pain syndrome (MPS) is an acute or chronic inflammatory condition that originates from the muscle and surrounding fascia. The fascia is the thin connective tissue that surrounds your muscles. Symptoms of MPS include localized discomfort and reduced range of motion in the affected area.
Physical examination in patients with MPS may reveal muscle trigger points. These are small bumps, knots, or nodules that commonly cause pain when touched. These also tend to develop as MPS becomes more chronic.
Acute MPS tends to resolve after simple treatments while chronic MPS may last for several months. Dry needling has been proposed as a potential treatment option to relieve pain and improve range of motion.
In the article below, we look at the applications of dry needling and how using it alongside other proven recovery aids may further improve its effectiveness. We explore the potential applications for MPS alongside other possible therapeutic benefits.
What is dry needling?
Dry needling is a recovery method carried out by physical therapists, acupuncturists, and other qualified healthcare professionals. It is commonly used to treat musculoskeletal pain and movement issues caused by conditions such as MPS.
In most cases, it’s used as part of a larger treatment plan alongside physical exercise, massage techniques, and stretching.
During the procedure, sharp needles are inserted through the skin into the myofascial trigger points. This is done with the aim to decrease tightness, improve blood flow, and reduce discomfort.
Once a trigger point is located, the needle is inserted and moved around to try to stimulate a local twitch response. This quick muscle spasm is a sign that the muscle is reacting to the stimulus.
Stimulating a trigger point aims to draw the blood supply back to the affected area to flush the area and release tension. The needle may also stimulate the release of endorphins, your body's natural pain medication.
Dry needling may therefore have applications in populations suffering from:
- Myofascial pain syndrome.
- Headaches.
- Muscle tension and discomfort.
Combining red light therapy with dry needling
Red light therapy (RLT), also known as photobiomodulation (PBM) uses low wavelengths of red light to stimulate mitochondrial function in the cells. This is known as the powerhouse of each cell, regulating metabolic activity, cell division, and cell growth.
When red light stimulates mitochondrial function, your cells can work more efficiently. Scientific studies performed over the last 20 years have suggested several benefits. These include:
- Improved wound healing and tissue repair.
- Improved blood flow which is associated with reduced inflammation and pain.
- Improved hair growth in those with androgenic alopecia.
- Better cognition and memory for people with Alzheimer’s disease.
- Improved collagen production and skin complexion.
- Reduction in cancer treatment side effects.
Previous research looking at the benefits of dry needling to relieve discomfort caused by MPS has shown promising results. Recent research looking at the effects of dry needling and RLT suggests that combining the two treatments may provide additional advantages.
In the studies below, combining RLT with dry needling seems to provide similar results to dry needling alone or dry needling done outside the trigger point. With no detrimental effects noted, RTL may complement dry needling, helping to further reduce pain and improve function.
These are some of the suggested benefits of combining both recovery therapies.
Improves blood Circulation
Red light therapy improves blood circulation by increasing the amount of bioavailable nitric oxide (NO). This molecule acts as a chemical messenger inside the body, helping blood vessels to relax and widen. Modulating blood flow may have applications in patients with a variety of specific cardiovascular conditions, diabetes, and general poor blood flow.
The sustained contraction of the muscle bands in trigger points may cause local blood and oxygen deficiencies. This causes the small blood vessels to widen, increasing blood circulation, and promoting the supply of oxygen and nutrients to the tissues for healing. This can also help to remove unwanted waste products.
With this, both methods can be used to improve blood circulation by improving NO production and dilating blood vessels. When combined, the additive effects may have further therapeutic applications.
Relieves muscle and joint Pain
Red light therapy acts on the mitochondria of the cells to stimulate energy production. This increased activity may help to reduce inflammation and promote healing, repair, and cell proliferation in the injured area. When done correctly, this may help relieve muscle and joint discomfort.
Dry needling stimulates muscle trigger points to release tension and promote endorphin release. This may also help to reduce discomfort and improve function.
Both recovery methods stimulate the cells to release tension, promote healing, and reduce discomfort. When done together, this may provide further functional improvements.
Non-invasive, safe, and risk-free
Red light therapy is a non-invasive, painless treatment performed for small periods. The red light penetrates the outer skin layer, acting on the cells to promote several beneficial effects.
Studies looking at the safety profile of RLT when used for skin rejuvenation have reported a low risk of adverse events, even during pregnancy.
Dry needling stimulates the local area of pain without affecting function in other areas. It is classed as a minimally invasive procedure with little risk.
Both recovery methods have an excellent safety profile, with minimal side effects and risks reported throughout the literature.
Studies looking at them combined have so far reported no negative interaction effects. Because of this, they may complement each other, providing two beneficial treatments that are safe, minimally invasive, and present low side effects.
Accelerated healing
Although both methods use different cell mechanisms, both are thought to promote healing at a cellular level. Both may increase blood flow, reduce inflammation, and promote increased cellular efficiency.
Each of these concepts is designed to accelerate the healing process. Combining them may produce accelerated healing. Some of the scientific studies we’ve reviewed below show exciting results that further support this theory.
Studies showing the practical applications of red light therapy and dry-needling
Study 1: Low-level laser therapy and dry needling for myofascial pain syndrome of the upper trapezius muscle
Read the full research: Low-level laser therapy and dry needling for myofascial pain syndrome of the upper trapezius muscle: An interventional study
Key findings about dry needling and red light therapy:
- Both therapies improved many of the measured outcomes
- PBM performed better than dry needling in most metrics
- This study only compared one or the other, so we can’t draw conclusions on the use of both
Study strengths:
A key strength of this article is that it compares two techniques which are rarely looked at together, photobiomodulation and dry needling. Additionally, the study design is straightforward and easy to understand, comparing the two techniques with weekly measurements for four weeks. The metrics evaluated can also be seen as a strength as they are very practical, including pain, pain threshold, and range of motion.
Study limitations and challenges:
Many of the strengths that have been described are directly tied to weaknesses with the study as well. While it is novel to compare photobiomodulation to dry needling in myofascial pain, this study did not look at the combined effect of both, and also had no placebo for laser or dry needling. This means that we can’t rule out the placebo effects for both arms of this study. Furthermore, the study does not look at any molecular biomarkers which would have provided more placebo resistant data. Another limitation with this study is that data collection only lasts as long as treatment, and it would be interesting to see how long the positive effects of these treatments last after treatment concludes
Our thoughts on “Low-level laser therapy and dry needling for myofascial pain syndrome of the upper trapezius muscle: An interventional study”
This study shows the effectiveness of both photobiomodulation and dry needling for the treatment of myofascial pain, and provides us with a comparison of the two as well. Given how positive the results are, if nothing else this certainly shows potential for both treatments in treating pain and increasing range of motion. However, given the lack of placebo combined with the lack of a combination treatment arm, this study cannot fully back up the claims that it would like to make. We hope to see studies like this repeated with improved protocols that have both the methodology and statistical significance to demonstrate the impacts that these initial results suggest.
Study 2: Effects of Dry Needling and Low-Power Laser for the Treatment of Trigger Points in the Upper Trapezius Muscle: A Randomized Clinical Trial
Read the full research: Effects of Dry Needling and Low-Power Laser for the Treatment of Trigger Points in the Upper Trapezius Muscle: A Randomized Clinical Trial
Key findings about [pathology] and red light therapy:
- Both dry needling and photobiomodulation vastly outperformed the control group
- Both therapies continued to have efficacy a month after treatment
- While there was a control group, still no placebo or look at combination of treatments
Study strengths:
Compared to the previous study, one key strength is that this study has data from a month after treatment, which provides useful information for example how often to receive treatment. The experiential metrics used in this study can also be seen as a strength as they showcase what truly matters with the treatment of myofascial pain, which is the experience of it. The lack of other metrics directly leads to the next section…
Study limitations and challenges:
This study does slightly better than the previously discussed study in that there is a control group, but this is distinctly different from a placebo group. In most of the metrics looked, both PBM and dry needling performed much better than the control group, but they performed almost exactly the same. This is not suspicious in of itself, but really begs for a placebo arm for both dry needling and PBM.
A silly note is that the study lists 100 MW (megawatts) as the power for the photobiomodulation laser, which is undoubtedly a mistake and should be 100 mW (milliwatts), as 100 MW could blow a hole in a tank.
Our thoughts on [Effects of Dry Needling and Low-Power Laser for the Treatment of Trigger Points in the Upper Trapezius Muscle: A Randomized Clinical Trial]
This study provides additional evidence that both PBM and dry needling are effective tools for managing myofascial pain. However, these results should be taken as initial findings that need to be backed up with a controlled clinical trial. This article also goes more into the treatment of myofascial pain of the trapezius in general which provides useful context.
Micro-needling vs. dry needling with red light therapy
Micro-needling is a minimally invasive skin procedure that uses tiny needles to make holes in the top layer of the skin. Compared to dry needling, micro-needling penetrates the skin at a much smaller depth.
The holes made by the tiny needles stimulate the skin's healing process to produce more collagen and elastin. Both of these are proteins that help to keep the skin smooth and firm.
With this, micro-needling is mainly used for cosmetic purposes, with some less common medical uses. These include skin wrinkles, enlarged pores, stretch marks, and in some cases, hair loss. On the other hand, dry needling aims to improve blood flow, stimulate endorphin release, and decrease tightness.
Both dry needling and micro-needling have several suggested applications when combined with red light therapy. Microneedling and red light therapy both stimulate collagen and elastic production, resulting in firmer skin. This is perhaps the main potential application of combining these treatments.
Dry needling and RLT both work to stimulate the body at a cellular level, increasing blood flow, reducing inflammation, and improving discomfort. These are the main potential applications to consider when combining both treatments.
When choosing one of the methods to pair with RLT, dry needling seems to be the better option. While each of the three methods has proven applications, dry needling combined with RLT has the most current research that confirms no negative interactions.
Microneedling may have further beneficial skin applications when combined with RLT. However, future studies are needed to confirm this hypothesis.
In the future, it may be that microneedling can be used alongside RLT for the skin. Alongside skin applications, dry needling and RLT may mainly be used to reduce inflammation and improve discomfort via the cellular mechanisms listed above.
Conclusion
The results of the studies discussed above suggest that RLT may serve as a complimentary recovery aid when paired with dry needling. Applications include reducing discomfort and improving function in those with MPS.
With studies to date showing no negative interaction effects, the combination of RLT and dry needling appears to be an effective recovery method worth considering.
For more articles on red light therapy, read:
- Red light therapy 101
- NSAIDS vs Red Light Therapy - Kineon Academy
- A Ray of Hope: Red Light Therapy's Impact on Nerve Damage
- Red Light Therapy: A Natural Way to Combat Oxidative Stress?
References
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