The masterclass, presented by Barbara Cagnie, focuses on the historical background, mechanisms, and effects of dry needling, particularly in the treatment of myofascial trigger points. Cagnie explains the development of the concept of myofascial trigger points by Dr. Janet Travell and Dr. David Simons, and discusses the pathophysiology of these trigger points, which are hyperirritable spots in skeletal muscles that cause pain, often referred to areas distant from the source. The presentation delves into the mechanisms behind trigger points, such as excessive acetylcholine release and increased spontaneous electrical activity, which contribute to muscle contractures and pain. This understanding sets the stage for exploring how dry needling can address these issues by normalizing acetylcholine release and reducing electrical activity, thereby alleviating pain and inflammation.

In the second part, Cagnie discusses the neurophysiological and clinical effects of dry needling. She describes how dry needling, through techniques like pistoning and winding, can affect the muscle itself and reduce pain and inflammation, while also having potential central effects, such as modulating pain perception. The masterclass highlights that dry needling is primarily used for musculoskeletal disorders, with evidence supporting short-term benefits in pain reduction and functional improvement, particularly for neck and shoulder pain. Additionally, dry needling shows promise in treating neurological disorders by improving spasticity and pain, and it may also benefit scar tissue through enhanced microcirculation and tissue healing. Despite the positive clinical observations, Cagnie notes the need for further research to fully understand the long-term effects and mechanisms involved.

Barbara is a physiotherapist and manual therapist and a professor at the University of Ghent with a special interest in the treatment of neck pain. She has published lots of papers on the topic including various studies on dry needling.