Dry Needling to Relieve Myofascial Pain


Physical aches and pains are a given for healthy active adults. Even elite athletes suffer from tight achy muscle pain that lingers, interfering with sports performance and increasing the risk of injury. Bodily pain often stems from dysfunction in the muscle fascia, where some regions become tight, restricting movement and causing pain and imbalances along the musculoskeletal kinetic chain. Dry needling is an innovative method for releasing myofascial tightness and relieving pain.

Myofascial Pain Syndrome


Myofascial pain syndrome affects the muscle fascia, the thin sheet of connective tissue that covers and separates muscles, allowing them to glide freely during physical activity. The condition is marked by persistent muscle pain or tenderness, and the formation of hard tender knots beneath the skin’s surface. It can affect a single muscle or a muscle group, and is usually caused by the overuse of a muscle or repeated injuries to muscle tissue, often resulting from sports or exercise.

What are Trigger Points?


The tender knots associated with myofascial pain syndrome are called trigger points. They occur when injured muscles release an excessive amount of acetylcholine, a nervous system compound that functions as a neurotransmitter. The result is a hypersensitive nodule in a taut band of muscle tissue that can usually be felt beneath the skin. Sensitive muscle knots can trigger pain in other areas of the body that are seemingly unrelated.

Myofascial trigger points (MTPs) can be either active or latent. Active trigger points spontaneously cause pain locally, or trigger referred pain in other areas of the body. Active MTPs often cause muscle weakness and reduced range of motion. Latent trigger points are not painful unless stimulated. However, they can alter muscle activation patterns and also contribute to reduced range of motion.

How Dry Needling Works

Dry needling is a procedure that targets trigger points with the insertion of a thin needle. It is not an injection, but rather a stimulus similar to acupuncture. However, unlike acupuncture that seeks to balance the body’s energy meridians, dry needling is used to generate a twitch response in an MTP, to get it to release.

Dry needling is most effective when guided by ultrasound imaging, especially in deep muscle tissue where MTPs are difficult to detect. Ultrasound enables the clinician to accurately target the MTP, ensuring effective treatment results. Dry needling relieves local muscle pain and referred pain caused by MTPs. It may be combined with other treatment methods to eliminate myofascial pain and promote healing.

Dry Needling Treatment in NYC

If you suffer from myofascial muscle pain, or chronic pain of any origin, NYDNRehab offers the very best pain care in NYC. Unlike many doctors and therapists, we go beyond treating your pain to getting to its source, so you can live pain-free without drugs or surgery. We don’t stop until your pain goes away.

Our clinical director, Dr. Lev Kalika, is one of the foremost Dry Needling experts in the United States. Our needling procedures are guided by high-resolution ultrasound, to ensure precise and effective treatment, every time. Contact NYDNRehab today, and get rid of your pain so you can get back in the game of life.

Check out the resource below to read Dr. Kalika’s peer reviewed research on ultrasound guided dry needling.

About the Author

Dr. Lev Kalika is clinical director of NYDNRehab, located in Manhattan. Lev Kalika is the author of multiple medical publications and research, and an international expert in the field of rehabilitative sonography, ultrasound guided dry needling and sports medicine Dr. Kalika works with athletes, runners, dancers and mainstream clients to relieve pain, rehabilitate injuries, enhance performance and minimize the risk of injuries. His clinic features some of the most technologically advanced equipment in the world, rarely found in a private clinic.


Bubnov, Rostyslav, Lev Kalika, and Olga Golubnitschaja. “Implication of local muscle response to precise dry needling in clinical outcomes of treatment myofascial pain.”


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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