Acupuncture and dry needling.

It arises from traditional Chinese medicine. It consists of stimulating the acupoints by means of needles, relating them to the painful areas of the patient, where mechanical stimuli will be provoked to generate responses in the target tissues.

Mechanisms of action: Activation of afferent fibers from peripheral nerves that block nociceptive fibers, generation of endogenous opioid peptides, changes in neurotransmitters involved in pain, increased blood flow, and tissue damage accelerate remodeling and healing processes.

Point Types:
Meridian points: Described within the meridians.
Points outside meridians: Points that are not within the meridians but are related to them, have a fixed location and function.
Ashi Points: Points with spontaneous pain or pressure.

There are 361 acupoints within the described meridians (14 meridians), marked surface lines that have neuro-myofascial correspondences.

In a normal session between 10 – 12 needles are introduced. The insertion technique will consist of rotation and insertion until the tissues do not allow it.

Dry Needling
Invasive physiotherapy technique, which consists of the application of needles inside the body, without injecting any substance, only with mechanical stimuli. They will be inserted at points called myofascial trigger points (MTrP), to mainly treat myofascial pain syndrome (MDS).

Action mechanisms:
PSS: Hyperstimulation analgesia, stimulation of nerve fibers to block nociceptive impulses to higher centers, generation of endogenous opioid peptides
PSP: All the effects of PSS, washout of sensitizing substances, mechanical laceration of myocytes or motor plates to later regenerate, local stretching of contracted cytoskeletal structures (myocytes close to the puncture site), effects on blood flow and anti-inflammatory mechanisms. .

MTrP: Hyperirritable point within a taut band of skeletal muscle. Painful on pressure and may produce referred pain

Treatment: For this treatment it is important to diagnose the usual pain-provoking MTrP, so that the needle can then be accurately inserted into the point or into the overlying tissues, depending on the technique used.

Classification according to the insertion depth of the tool:
-Superficial dry needling (PSS): Needle does not reach the PGM
-Deep dry needling (PSP): Needle reaches the PGM.