Dry Needling- Mechanism of Action

Local Effects:
Mechanical Disruption of contraction knot causing immediate lengthening or relaxation of affected myofibril.
Destruction of motor end plates and distal axonal denervation. Hence the Ach release is diminished.
Increased capillary permeability and vasodilation leading to more ATP transfer, so the myosin head detaches from actin.
Release of Vascular Endothelial growth factor to promote vasodilation, angiogenesis, metabolism to reverse energy crisis.
Vasodilation induced satellite cell migration heals the damaged fibre to normal fibre.
LTRs results in immediate reduction of inflammatory mediators like CGRP, IL, Sub P, TNF etc to reduce chemical pain.
Localized stretch to cytoskeletal disentangles myosin from titin gel. Mechanical stimulation reorganizes actin cytoskeletal.
Piezoelectric effects of needling causes tissue remodelling.

Spinal/Segmental Effects:
A-δ stimulation release Enkephalin to inhibit Substantia Gelatinosa (SG) - Segmental block(Pain Gate Mechanism).
Same effects observed at the contralateral side and segments above and below, so pain reduction occurs in distant sites.
Needling also stimulates A-β fibres to cause similar segmental blocks. Effects continue up to 72 hours.

Descending Pain Control/Cortical Effects:

Central Adrenergic & Serotonergic neurons by needling, release chemicals to block SG- Descending Pain Inhibition.
Diffuse noxious inhibitory control, Nor Adrenergic system control, A- δ stimulation mediated Enkephalin, Serotonergic,
Dynorphin chemical releases, are all attributed to Descending Pain Control- Powerful to Shut down any pain.
Reduction in peripheral nociception reduces Central sensitization and reverses the pathological neuroplasticity.