This is part 2 of last week's post - How I integrate Dry Needling of Myofascial Trigger Points in a course of Physiotherapy
Be aware of ‘dose’ i.e. level of sensory input applied to the central nervous system. Dry needlers are notorious for providing too high a dose during treatment due to use of very vigorous techniques. I feel there is not enough emphasis on dose control during training.
Control dose by the no. of needles used, depth, duration and level of stimulation applied i.e. gentle rotation< lift thrust
Remember dose is cumulative, be careful with needling and then doing manual therapy and exercise as all provide sensory input. If including needling in treatment, any soft tissue therapy should be very gentle and short of pain, see above, so as not to ‘over-treat’ the patient.
The dose should be carefully titrated upwards until a therapeutic response is achieved and then maintained at that level. May need to increase dose slightly if patient response starts to plateau.