Dry Needling

Dry Needling, soms ook IntraMusculaire Stimulatie, “IMS” genoemd, is een behandelmethode die wordt toegepast voor de behandeling van chronische pijn en myofasciale problemen; stijfheid en pijn in de spieren. Kenmerkend voor deze problematiek zijn ’triggerpoints’: drukgevoelige plaatsen in de spieren.

De methode is ontwikkeld in de jaren zeventig van de 20ste eeuw door de Canadese arts C. Chann Gunn. De behandelmethode is in 2007 door het Koninklijk Nederlands Genootschap voor Fysiotherapie opgenomen in het beroepsprofiel van de fysiotherapeut. De behandeling valt in Nederland onder de reguliere zorg van de fysiotherapie

Een patiënt met myofasciale pijn heeft last van stijfheid en vaak acute of zelfs chronische spierpijn. Wanneer spieren te gespannen zijn, kunnen zich pijnlijke en verharde plekken vormen; de triggerpoints. De spierproblemen kunnen vaak door een geschoolde dry needling therapeut (fysiotherapeut of manueeltherapeut) worden verholpen. Het aandrukken van een triggerpoint wekt meestal dezelfde pijn op waar de patiënt last van heeft. Deze pijngebieden worden ook wel reffered pain patterns genoemd.

De zienswijze die ten grondslag ligt aan deze vorm van pijnbehandeling komt neer op het herstellen van de supersensitiviteit. De zenuw functioneert niet goed en uiteindelijk ontstaat er pijn in het overeenkomstige zenuw segment. Het gevolg van de zenuwdisfunctie is dat de organen (waaronder de spieren) die afhankelijk zijn van de zenuw verhoogd gevoelig worden.

Volgens het Dry Needling-principe van Dr C.C. Gunn wordt gekeken naar de volgende stoornissen:

  1. spieren hebben meerdere pijnlijke spierknopen of strengen (myofasciale triggerpoints);
  2. andere spieren in hetzelfde segment hebben ook strengen of spierknopen;
  3. corresponderende spieren aan de andere kant van het lichaam hebben ook strengen en spierknopen;
  4. huidgebieden die corresponderen met deze spiersegmenten laten functieverstoringen zien zoals gelokaliseerd (dermatomaal) haarverlies, matige vochthuishouding, versterkte reactie op koudeprikkels (bijvoorbeeld snellere kippenvelreactie en snellere blauwige verkleuring). Soms is voelbaar dat een betreffend huidgebied kouder is;
  5. diepliggende, tot hetzelfde segment behorende spieren van de wervelkolom zelf zijn verkort, verhard en pijnlijk.

Een therapeut kijkt tijdens het onderzoek en de behandeling naar signalen van neuropathie. Tijdens de behandeling wordt gebruikgemaakt van dunne acupunctuurnaalden. Deze worden gebruikt om een zogenaamde “release” van de spier te verkrijgen. De spier wordt geprikkeld met een dunne naald. In eerste instantie ontstaat een reflexmatige verkramping van de spier, dit wordt een Local Twitch Respons genoemd. Die wordt door de patiënt waargenomen. De bedoeling is dat naderhand de spier loslaat. Dat kan direct zijn (de patiënt voelt dan onmiddellijk een soort “losheid”), maar kan ook pas later optreden. Meer ontspanning in de spier betekent dat de doorbloeding kan toenemen en herstel kan optreden. De mobiliteit in de aanliggende gewrichten kan verbeteren. Het uiteindelijke doel van Dry Needling is dat de “neuropathie” zich geleidelijk herstelt. De pijn neemt af en de spier en gewrichtsfunctie neemt toe.

Dry Needling is geen acupunctuur en heeft in tegenstelling tot acupunctuur geen energetisch kader en er wordt geen gebruik gemaakt van meridianen om de aanprikpunten te bepalen.

 

 

 

 

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