Dry Needling Burn Scar

What is Dry Needling?

Dry Needling or Intramuscular Stimulation (IMS) is an effective treatment for chronic nerve pain. The technique is also unequaled for finding and diagnosing muscle shortening in deep muscles.

The acupuncture needle used is very thin (much thinner than the hollow needle used to inject medicine or take blood samples).  You may not even feel it penetrating the skin, and if your muscle is normal, the needle is painless.  However, if your muscle is supersensitive and shortened, you’ll feel a peculiar sensation, like a muscle cramp or Charlie Horse. This is a distinctive type of discomfort caused by the muscle grasping the needle.  Patients soon learn to recognize and welcome this sensation.  They call it a “good” or positive pain because it soon disappears and is followed by a wonderful feeling of relief and relaxation.  The needle may still be in you, but because the muscle is no longer tight, you no longer feel it.  What has happened is that the needling has caused your abnormal muscle shortening to intensify and then release.  It is important that you experience this sensation in order to gain lasting relief.

Needling stimulates a certain amount of healing, until eventually, the condition is healed and the pain disappears.  Some patients treated with dry muscle needling have remained pain free for over 20 years.

Frequency of Treatments

Physical Therapy treatments involving dry needling are usually once a week (but can be spread out to two weeks) to allow time between treatments for the body to heal itself.  The number of treatments you require will depend on several factors such as the duration and extent of your condition, how much scar tissue there is (usually increased after previous surgery) and how quickly your body can heal.  The rate of healing depends on the condition of your nerves.  If the pain is of recent origin, one treatment may be all that is necessary.  On average though, you are more than likely going to require between 8 and 10 treatments.

“The Shortened Muscle Syndrome”

An important factor in neuropathic pain is muscle shortening, caused by muscle spasm and contracture.  Muscle shortening produces pain by pulling on tendons, straining them as well as distressing the joints they move.  Muscle shortening also increases wear and tear and contributes to degenerative changes such as “tendonitis”, and osteoarthritis”.  These conditions are customarily regarded as “local” conditions and may not receive the appropriate diagnosis or the most effective physiotherapy treatment.

Involvement of the Spine

The most common cause of nerve irritation and neuropathic pain is degeneration in the spine, which can be the result of normal wear and tear. 

Skin Needling, is accomplished by utilizing a certain technique while inserting the needle into the top layer of the epidermis. This technique is best accomplished when it is used quite shallow in the skin.

Scar Relaxation is a specific well-designed application to help create supple skin texture.

The technique for both Needling and Scar Relaxation is the application of repetitive circular movements called ‘obovoids’.

Scar Relaxation is used primarily to soften the fibrous bands of collagen (scar tissue) to give the patient more flexibility in their movements. This procedure works well on all contracted tissue with exceptional results on the hands.

Dry needling, like acupuncture, and manual soft-tissue manipulation are tools that can release scar contractures and interior adhesions.

The can also make scars less obvious by using a tattoo gun to "needle abrade" the scars. As I understand it, this technique works because the needles break old collagen strands that are tethering the bed of the scar, and the damage also creates more collagen immediately under the epidermis.

Because the needle only penetrates through the epidermis and does not remove it, the epidermis is only cleft and will rapidly heal. As the skin swells, the holes are closed and the edges of the epidermis are approximated. The needle prick injures the upper 1 - 2 mm of the dermis. This injury, minute as it might seem, does cause some localised damage and bleeding. This will promote the normal post-traumatic infiltration of fibroblasts and the release of growth factors. Ultimately, collagen is laid down in the papillary and upper reticular dermis. This is an un-important response if we are looking at a single needle prick through the skin. A completely different picture emerges when one has thousands of fine pricks next to each other. The process can become virtually confluent, and as a result, may mimic the results obtained with a laser, but without destroying the epidermis. It may be that with deeper penetration into the dermis, better collagen and elastin deposition will be obtained.
 

The Technique
 Dr. Des Fernandesis an expert in this technique and says he uses a tattoo-artist's gun with 4/5 needles in a straight row. The skin must be held tightly and the excursion should be sufficient to penetrate skin. It is usually easier to work in the Langer's line but I also work in a contrary direction as well.
 
 Healing
 The skin is crimson coloured immediately after the treatment but bleeding is minimal and stops pretty soon. After all this is only a pin-prick.! I have treated the skin with granulflex, with Tegaderm or simply leaving the skin exposed and covered only with a vitamin A and antioxidant vitamin gel. "My impression is that healing is better when the skin is left exposed and covered with BIOSKINCARE", as he states has been his experience.
 
By day 4 to 5 the skin has returned to a moderate pink flush which is usually easily covered with make-up. The oedema of the face rapidly becomes un-noticeable, though one may notice "water-bags" for up to three months on the malars after treating the lower eyelids. At the same time collagen and elastin are building up and the skin gradually tightens up. The process can be repeated at anytime after the epidermis has healed completely.

Contraindications: Not for type IV, V and VI skin where pigmentation of the scars may occur.

 

Dry Needling Burn Scar

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