Musculoskeletal pain is common, leading many people to seek effective treatment options. In recent years, dry needling, a technique involving fine filament needles, has gained attention for addressing muscle and joint discomfort. This approach has shown promise for managing various painful conditions. The question often arises whether this technique can be applied to joint-related issues, specifically bursitis.
Defining Bursitis
Bursitis is a painful condition resulting from the inflammation of a bursa, a small, fluid-filled sac found throughout the body. Bursae act as cushions, reducing friction between muscles, tendons, and bones, allowing for smooth joint movement. When irritated, the sac’s lining thickens and produces excessive fluid, leading to localized swelling and pain. Inflammation typically occurs due to repetitive motion, overuse, or trauma; common locations include the shoulder, elbow, hip, and knee. Symptoms involve localized tenderness, pain that worsens with movement, and sometimes warmth or redness over the affected joint.
The Mechanics of Dry Needling
Dry needling is a therapeutic procedure involving the insertion of thin, filiform needles into specific muscle tissue areas. The primary target is the myofascial trigger point—a hyperirritable knot or taut band within a skeletal muscle. The procedure aims to improve musculoskeletal function. When a needle is inserted into an active trigger point, it often elicits a brief, involuntary muscle contraction known as a Local Twitch Response (LTR). Eliciting the LTR indicates successful deactivation of the trigger point, which helps normalize chemical signals in the muscle tissue and reduce muscle tension.
Targeting Bursitis with Dry Needling
Dry needling is generally not performed directly into the inflamed bursa due to the risk of irritation or infection. Instead, it is used as an indirect therapy to address muscle dysfunction that contributes to bursitis. The approach focuses on the musculature surrounding the affected joint, such as the rotator cuff for shoulder bursitis or hip abductors for trochanteric bursitis. Chronic bursitis often causes compensatory tightness and trigger points in surrounding muscles as they attempt to stabilize the painful joint. By deactivating these trigger points, dry needling reduces the mechanical stress and compression tight muscles place on the bursa, which helps decrease overall pain and allows the inflamed bursa to heal more effectively.
Safety Profile and Contraindications
Dry needling is considered a minimally invasive treatment with a low risk of serious complications when performed by a trained practitioner. Common minor side effects include temporary soreness, mild bleeding, and bruising at the insertion sites, which typically resolve within a day or two. Rare but more serious risks include nerve irritation, infection, or a pneumothorax (punctured lung) in the chest area. There are specific situations where dry needling should be avoided, which are known as absolute contraindications:
- Inability to give consent.
- Severe needle phobia.
- Local or systemic infections.
- Areas with compromised skin integrity.
Caution is also warranted for patients with abnormal bleeding tendencies, those on anticoagulant therapy, or individuals with a severely compromised immune system.