By Gabriel Pallante, PT, DPT, IADN Cert. Specialist

Dry needling combined with microcurrent electrical stimulation, between
1-5Hz, offers a promising approach to regulating the autonomic nervous
system (ANS), which is crucial for maintaining overall homeostasis or balance
within the body. Currents below 500 microamps appears to stimulate cellular processes that lead to the production of adenosine triphosphate (ATP). This is hypothesized to occur through the influence on ion movement, such as protons, across cellular and mitochondrial membranes, which affects ATP synthesis within the mitochondria. Homeostasis is akin to a state of harmony rather than a mere balancing act, and the use of electrical stimulation can play a significant role in achieving this balance.

Electricity is a fundamental concept bridging physics, chemistry, and
biology. In the human body, electricity underpins nerve impulses, muscle
contractions, and various cellular processes. The introduction of external
electrical stimulation, such as microTENs (transcutaneous electrical nerve
stimulation), can harness these natural electrical principles to support ANS
regulation and alleviate pain. There is rationale for placement of the positive and
negative leads, depending on tissue quality.

The Gate Control Theory of pain modulation provides a basis for how
electrical stimulation can be beneficial. According to this theory, pain signals
are processed through different channels in the spinal cord and brain, similar
to a bank teller serving one customer at a time. By applying the positive lead
to pathologic, painful areas, the thought using the Gate Control theory is to override the pain signals coming from the smaller, less myelinated, C and delta fibers with stimulation of larger, more myelinated alpha and beta fibers, effectively altering their perception and reducing discomfort. However, the true underlying reason that placing the positive lead on painful tissues decreases pain is because it makes the extracellular space more positive, reducing the electric potential between the inside and outside of the cell, making muscles less likely to spontaneously fire and contract. Normalizing the electric charge of cells normalizes epigenetic and genetic expression and induces autonomic nervous system homeostasis. The key to health.

Dry needling, when paired with microTENs electrical stimulation,
enhances this process by influencing cellular ionization and restoring
balance. Electrodes attached to the needles can be strategically placed with
positive and negative leads to exploit the principles of ion flow and electrical
gradients. For example, placing the positive lead on a painful site and a
negative lead on a contralateral area can help disrupt pain pathways and
modulate signals sent to the brain, and from the brain back to the muscles.

On a cellular level, this stimulation affects ion concentrations. Ions like
sodium, potassium, magnesium, and chloride are essential for nerve function and muscle
activity. By applying electrical stimulation, the body’s ion
gradients are influenced, aiding in the normalization of cellular
resting potentials. Specifically, overstimulated tissues, which may have
deviated from their optimal resting potential of -70mV to a less negative and more likely to fire state, can be encouraged to return to baseline through thoughtful application of the negative and positive leads.

Note: Remember, normal resting muscle cell potential for skeletal muscle is about -70 millivolts, or so. An action potential typically occurs at +40 millivolts, or so. Also remember, the vast majority of PT patients present with sympathetic hyperactivity of both the ANS and CNS. With hyperactive sympathetics, the resting potential of the sarcomere is less negative, maybe at -50 millivolts, and the action potential is less positive, maybe around +30 millivolts. In this instance, the electrical potential of the cell needs to change far less to stimulate an action potential. This is one of the reasons that sympathetically hyperactive sarcomeres produce spontaneous electrical activity.

Furthermore, the stimulation of parasympathetic dominant areas
promotes a shift from sympathetic dominance. The sympathetic nervous
system, responsible for the fight-or-flight response, when overactive,
contributes to chronic pain and stress. By stimulating areas that favor
parasympathetic activity, the body is nudged towards a state of rest and
recovery, reducing the overall sympathetic drive and promoting homeostasis.
The result of this approach is a reduction in pain and discomfort,
improved blood flow due to vasodilation, and a decrease in excitatory
neurotransmitters like acetylcholine. This helps the body reset its internal
state, fostering a more balanced nervous system and enhancing patient
outcomes.

In summary, dry needling with microTENs electrical stimulation
effectively leverages the foundational principles of electricity
to support autonomic nervous system regulation. This technique
helps modulate pain, restore cellular ion balance, and promote overall
homeostasis, the key to health and well-being.