Dry Needling (IMS) Treatment for Shoulder Pain

What is the rotator cuff?

The rotator cuff is a group of tendons and muscles in the shoulder, connecting the upper arm (humerus) to the shoulder blade (scapula). The rotator cuff tendons provide stability to the shoulder; the muscles allow the shoulder to rotate.

What are common causes of rotator cuff injuries?

Rotator cuff injuries commonly occur due to wear and tear with age (repetitive overuse, especially overhead), or traumatic injuries to the shoulder. This can result in pain, weakness and an inability to continue activities that involve shoulder use.

Common Rotator Cuff Conditions

• Rotator cuff tear: An injury tears a rotator cuff tendon that’s been weakened by age or wear and tear. Weakness in the arm (and usually pain) are the symptoms.
• Rotator cuff tendinitis: Repetitive overhead use of the arms (such as painting, overhead weight lifting or throwing) causes a painful strain injury.
• Rotator cuff impingement: The tendons of the rotator cuff are squeezed between the humerus and a nearby bone called the acromion. Symptoms and treatment of impingement are similar to tendinitis.
• Subacromial bursitis: Inflammation of the small sac of fluid (bursa) that cushions the rotator cuff tendons from a nearby bone (the acromion).

Dry Needling for rotator cuff injuries

Dry Needling, also known as Intra-Muscular Stimulation (IMS), is a technique used by physiotherapists and physicians to treat pain arising from muscles and/or nerves. Dry Needling is based on Western Medical Science and involves inserting a needle, without medication or injection, into an area of the muscle known as a trigger point.
A trigger point is an irritable, hard “knot” within a muscle that is painful when palpated and can produce significant pain over a large area (see Figure 1). Trigger points are very common in painful shoulders¹, and can contribute to pain, shortening of muscles, loss of motion, muscle dysfunction, and altered movement and strength.
Research¹ supports the use of dry needling to release trigger points and tension in the rotator cuff. This can significantly decrease shoulder pain, improve mobility, promote healing and restore function. Your physiotherapist will often combine dry needling with other treatments, such as manual therapy (hands-on-treatment), specific exercises, and education on postures/technique.

Figure 1. Infraspinatus trigger point (Simons, 1983)

Practical advice

• Repetitive overuse, especially overhead motions, is a common cause of shoulder pain. Minimize repetitive lifting, reaching or throwing if they are painful, and follow-up with your family doctor or physiotherapist. Athletes (eg., swimmers) may also require technique adjustment.
• Be conscious of your posture. Poor posture can make shoulder pain worse. For those who work a desk job, stand up and take frequent rest breaks to prevent your shoulders from falling forward.
• Avoid sleeping on the painful shoulder
• Use a stool to reach for overhead items at home or at work
• Ice can be helpful to manage acute shoulder pain
• Follow up with your family doctor or physiotherapist

Getting Dry Needling Treatment in Burnaby, B.C.

For more information or to book an appointment at Burnaby Physio Care, please call us at 604-558-CARE (2273) or get in touch with us online to learn more and to schedule treatment.

Blog written by Reza Ghannadan, Physiotherapist who is Certified in Dry Needling (IMS) at our Burnaby Physiotherapy Clinic.

References:

1. Sergienko, S. & Kalichman, L. (2015). Myofascial origin of shoulder pain: a literature review. Journal of Body Works and Movement Therapies, 19(1).

2. Simons, D. G., Travell, J. G. & Simons, L. S. (1983). Myofascial Pain and Dysfunction: The Trigger Point Manual: The Upper Extremities. Vol.1 . Baltimore, Md: Williams & Wilkins.