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Australian Osteopathic Association 31
a local twitch response (LTR) has been shown to decrease
the tone of the muscle/ trigger point as well as decreasing
pain and spontaneous electrical activity (SEA) associated with
active trigger points [Shah 2008].
It also reduces the presence of local inflammatory mediators,
commonly associated with active trigger points, and increases
the range of motion limited by shortened motor bands.
The effect is often immediate with noticeable improvements
in range of motion, pain and function.
CAN DRY NEEDLING BE TAUGHT IN
A THREE-DAY COURSE?
The answer is yes, because the concepts of treating trigger
points are well known to osteopaths.
Inhibiting a trigger point to decrease tone in a tight muscle
or motor band is common in osteopathic practice. The only
real difference with dry needling is you are now using a fine
filament needle to access that trigger point rather than using
your fingers, hands or elbow.
Learning to handle the needle safely, understanding the
3D anatomy of the patient, choosing the right needle to use
and how to apply it effectively, takes every bit of the three
days but the concept is quite simple.
It just takes some time with the supervision of an instructor
to become confident handling and applying the needle.
The benefit of using a needle is that you can reach almost any
muscle and to its full depth, right down to the bone in many cases.
Lumbar mutifdus is a classic example where soft tissue
techniques are limited by the ability of the practitioner to
access the deep layers of this muscle. A needle can be inserted
right down to lamina if required.
The question of whether dry needling fits within the scope
of practice of osteopathy is a simple one. Osteopaths have
been releasing trigger points, reducing neural sensitivity and
improving range of motion and blood flow for more than 100
years. They have been refining and developing new skills and
techniques that whole time. Dry needling is just a different
way of applying those concepts in a highly effective and
The confusion regarding acupuncture is that they use
the same implement, being a needle. Acupuncture is too
complicated to be taught in a weekend, just as osteopathy
cannot be taught in a weekend.
Dry needling is an extension of the skills and knowledge
already learned in undergraduate study, and therefore
an introductory course is entirely appropriate to learn this
new skill. •••
Editor's note: The AOA is likely to produce some minimum
training standards for needling courses eligible for Guild
Insurance in 2014. Research has highlighted significant
variability in the ability to detect trigger points; but the AOA
has concerns regarding osteopaths with minimum training on
any needling technique or point selection and pneumothorax
Craig White is an osteopath at Kingston Spinal and Osteopathic Clinic in
Victoria and is co-presenter of Trigger Point Dry Needling courses with GEMt.
• YouTube and search for C. Chan Gunn
• The GEMt website: www.gemt.com.au
• The ScienceDirect website and search for The Effect of Dry
Needling on Pain, Pressure Pain Threshold and Disability
in Patients with a Myofascial Trigger Point in the Upper
• PubMed and search for: Uncovering the biochemical milieu
of myofascial trigger points using in vivo microdialysis: an
application of muscle pain concepts to myofascial pain
syndrome by J.P. Shah and E.A. Gilliams
(J Bodywork Movement Ther 2008; 12:371-384.
• Osteopath Luke Rickards’ blog: ww w.lukerickardsosteopath.
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