Neurophysiological effects of latent trigger point dry needling on spinal reflexes.

Abstract

Deep dry needling (DDN) is a method to treat muscle trigger points (TrPs) often found in persons with neuromuscular pain and spasticity. Currently, its neurophysiological actions are not well established. Thus, to understand how DDN affects spinal cord physiology, we investigated the effects of TrP DDN on spinal reflexes. In 17 adults with latent TrPs in the medial gastrocnemius (MG) without known neurological or orthopedic injuries, the H reflex, M wave, and reciprocal inhibition in the soleus, MG, and lateral gastrocnemius (LG) and passive ankle range of motion (ROM) were measured before and immediately, 90 min, and 72 h after a single bout of DDN at the MG TrPs. The MG maximum M wave (M_max) amplitude was decreased immediately and 90 min post DDN (by -14% and -18%) and returned to pre-DDN level at 72 h post. LG and soleus M_max did not change. The maximum H reflex (H_max) amplitude did not change in any of the triceps surae. Soleus inhibition was increased significantly immediately (+30%) and 72 h (+36%) post DDN. ROM was increased by ≈4° immediately and ≈3° at 72 h post DDN. Temporary reduction of MG (but not soleus or LG) M_max amplitude after DDN and its recovery at 72 h post indicate temporary and specific effects of DDN in the treated muscle. The immediate and 72 h post increases in the ROM and soleus inhibition with no changes in H_max suggest complex effects of DDN at the spinal level.NEW & NOTEWORTHY In this study, we examined the effects of deep dry needling (DDN) on spinal reflexes in the triceps surae. We found that the H reflex (an excitatory reflex) did not change after DDN but soleus inhibition was increased immediately and 72 h after DDN, corresponding to increases in ankle range of motion. Differential effects of DDN on excitatory and inhibitory reflexes over the first 72 h may reflect its complex neurophysiological effects at the spinal level.