Page 49 - Journal of Special Operations Medicine - Winter 2016

Trigger-Point Dry Needling for the SOF Medic

Thomas Cavett, BA; Justin Solarczyk, BS

ABSTRACT

We propose that trigger-point dry needle (TrP-DN) Trigger-point dry needle therapy (TrP-DN), a minimally
therapy is an effective low-risk treatment for pain as- invasive needle treatment for musculoskeletal pain,
sociated with myofascial trigger points (MTrP), and targets myofascial trigger points (MTrPs) that are be-
should be incorporated into the Special Operations lieved to contribute significantly to chronic pain associ-
Forces (SOF) Medic’s scope of practice. Furthermore, ated with musculoskeletal injuries. We propose that
1–4
TrP-DN therapy can be used as a treatment adjunct on TrP-DN therapy is an effective, low-risk treatment for
the SOF continuum of care, providing analgesia and in- musculoskeletal pain associated with MTrPs, and that
creased tolerance for rehabilitative therapy, thereby fa- it should be incorporated into the SOF Medic’s scope
cilitating improved patient outcomes and faster return of practice. Furthermore, TrP-DN therapy can be used
to operational readiness. The incidence of musculoskel- as a treatment adjunct on the SOF continuum of care.
etal injuries in the SOF community is discussed, as are TrP-DN may provide decreased pain and increased tol-
available treatment options TrP-DN methods, a case erance for rehabilitative therapy, thereby facilitating
study of a Soldier deployed to Afghanistan, the science better patient outcomes and a faster return to opera-
behind the subject of MTrP and TrP-DN, and the risks tional readiness.
associated with TrP-DN and how we can mitigate them
effectively. Caution should be used in the interpretation Although this therapy is available in garrison through
of a body of literature based largely on case studies. our Tactical Human Optimization, Rapid Rehabilita-
Although the amount of published evidence in support tion and Reconditioning (THOR3) physical therapists
of the potential benefits of TrP-DN is growing, larger, and other providers, many SOF personnel spend a ma-

randomized, placebo-controlled trials and studies that jority of the year deployed, away from these therapists.
evaluate the effects of TrP-DN in a methodologically Throughout Operation Iraqi Freedom and Operation
rigorous and statistically significant way are needed. Enduring Freedom, the Army has attempted to maintain
Based on anecdotal evidence of and personal experience an average dwell ratio, or the proportion of time de-
with the success of the therapy, as well as its growing ployed to the time at home, of nearly 1:1; however, SOF
use within both civilian and military medicine, the pos- has historically exceeded this. In 2010, for example, the
5
sible therapeutic benefit of TrP-DN is relevant for the average US Army Special Forces Command dwell ratio
SOF community. was 1:0.63. 6

Keywords: myofascial trigger points; myofascial pain syn- Here, we discuss the incidence of musculoskeletal inju-
drome; military; case study ries in the SOF community and treatment options avail-
able. We provide an explanation of TrP-DN methods.
We use the case study of a Soldier deployed to Afghani-
stan to provide anecdotal evidence of the treatment’s ef-
Introduction
fectiveness. Last, we introduce the science behind the
After over 14 years of back-to-back deployments, the subject of MTrP and TrP-DN, the current gaps in re-
average Special Operations unit is filled with individ- search trials, and discuss the risks associated with TrP-
uals who have chronic injuries. Given a high opera- DN and how we can mitigate them effectively.
tional tempo in austere locations, Special Operations
Forces (SOF) are often unable to access the specialty SOF Musculoskeletal Injuries
and rehabilitative care they need to address many com-
mon musculoskeletal injuries. Additionally, SOF Medics As SOF Medics, we see a wide range of musculoskeletal
are limited to basic rehabilitative exercises, stretching, injuries daily. Many of these are minor and can be easily
rest, and pharmacologic therapy to treat these complex resolved with basic treatments such as rest, ice, compres-
issues. sion, elevation, simple stretching and exercise regimens,

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