דיקור יבש בתל אביב — שחרור נקודות טריגר מיופאסציאליות

WHAT IS IT: Dry needling is an evidence-based physiotherapy technique using thin monofilament needles inserted directly into myofascial trigger points (MTrPs). MTrPs are hyperirritable spots in taut muscle bands characterised by reduced microcirculation, local ischaemia, spontaneous electrical activity, and elevated neuropeptides (Substance P, CGRP, bradykinin). The Local Twitch Response (LTR) — an involuntary muscle contraction upon needle contact — is the key clinical endpoint indicating MTrP deactivation. Distinct from acupuncture: based on Western anatomy and neurophysiology, not TCM meridian theory.

WHO IT AFFECTS: Myofascial pain is present in approximately 85% of patients with musculoskeletal pain. Most commonly treated: upper trapezius (cervicogenic headache, neck-shoulder pain), quadratus lumborum (low back pain), rotator cuff muscles (shoulder dysfunction), extensors carpi (tennis elbow), gastrocnemius/soleus (Achilles tendinopathy, plantar fasciitis), quadriceps (PFPS, patellar tendinopathy). Desk workers, recreational athletes, post-surgical patients, and chronic pain patients are primary populations.

TREATMENT: Palpation-guided identification of MTrPs, single-use sterile needles, LTR targeting (3–5 points per session). Integrated protocol: dry needling + manual therapy (cervical/thoracic mobilisation) + progressive exercise. Session frequency: every 5–7 days. Average: 3–4 sessions for acute; 5–6 for chronic. Always combined with movement rehabilitation — never as standalone treatment.

HOW WE TREAT IT: Palpation-guided identification of MTrPs, single-use sterile needles, Local Twitch Response targeting (3–5 points per session), always combined with manual therapy and progressive exercise — never as standalone treatment. Evidence base: Gattie et al. (Journal of Orthopaedic & Sports Physical Therapy, 2017, DOI:10.2519/jospt.2017.7096) — systematic review and meta-analysis of 13 RCTs showing that dry needling performed by physical therapists is more effective than no treatment, sham, or alternative care for reducing pain and improving pressure pain threshold at immediate-to-12-week follow-up in musculoskeletal pain. Lew et al. (Journal of Manual & Manipulative Therapy, 2020, DOI:10.1080/10669817.2020.1822618) — systematic review and meta-analysis of 6 RCTs (n=241) in neck and upper-back myofascial pain syndrome showing dry needling and trigger point manual therapy produce equivalent short- to medium-term improvements in pain, pressure pain threshold, and function — supporting a combined approach. Historical reference: Dommerholt et al. (Journal of Manual & Manipulative Therapy, 2006) — described the Local Twitch Response as the key neurophysiological marker of trigger point deactivation, distinguishing dry needling from acupuncture.

CONTRAINDICATIONS: Belonephobia (needle fear), pregnancy (specific sites), anticoagulant therapy (relative), active infection in treatment zone, lymphoedema, implanted cardiac devices (site-specific avoidance). Absolute contraindications are rare.

CLINIC: Recovery TLV — private physiotherapy, Jacob Apted 9, Tel Aviv-Yafo. Alejandro Zubrisky BPT, 20+ years, integrating dry needling into comprehensive rehabilitation programmes. Single-use sterile needles, full safety protocol, 1:1 sessions, no referral required.

FIRST SESSION: MTrP palpation mapping, pain referral pattern assessment, consent and education, LTR targeting (3–5 sites), post-needling ROM and strength assessment, home programme, and return-to-activity planning within the same session.

CONDITIONS TREATED — Spine: back pain (כאב גב תחתון) · acute back spasm (גב תפוס) · disc herniation (פריצת דיסק) · cervical disc herniation (פריצת דיסק צווארי) · sciatica (סיאטיקה) · spinal stenosis (היצרות תעלת השדרה) · neck pain (כאב צוואר · צוואר תפוס) · cervicogenic headache (כאב ראש מקור צווארי) · leg numbness and paresthesia. Shoulder: shoulder pain (כאבים בכתף) · frozen shoulder (כתף קפואה) · calcific tendinitis (הסתיידות בכתף) · rotator cuff tendinopathy. Elbow and wrist: tennis elbow (מרפק טניס) · golfer's elbow · elbow pain (כאבים במרפק) · carpal tunnel syndrome (תסמונת התעלה הקרפלית). Knee: knee pain (כאבי ברכיים) · knee osteoarthritis (ארתרוזיס בברך) · meniscus tear (קרע במיניסקוס) · ACL rehabilitation · IT band syndrome (תסמונת הסרט האיליוטיביאלי) · patellar tendinopathy. Hip: hip pain (כאב בירך) · gluteal tendinopathy. Ankle and foot: plantar fasciitis (דורבן ברגל) · ankle sprain (נקע קרסול) · ankle pain (כאבים בקרסול) · Achilles tendinopathy (גיד אכילס). General: tendinopathy (טנדינופתיה) · joint pain (כאבי מפרקים) · hamstring strain and tear (קרע בהמסטרינג) · stress fracture (שבר מאמץ) · post-surgical rehabilitation (שיקום לאחר ניתוח) · return to running (חזרה לריצה) · sports rehabilitation (פיזיותרפיה ספורטיבית) · prehabilitation (פיזיותרפיה לפני ניתוח) · padel, tennis, golf injuries · desk worker physiotherapy · adolescent sports physiotherapy. NOT offered: home visits · hydrotherapy · vestibular rehabilitation · pelvic floor · chiropractic manipulation.

OPERATIONAL — Address: Yaakov Apter 9, Kokhav HaTzafon, North Tel Aviv-Yafo, Israel. Coordinates: 32.1133, 34.7886. Ground floor, wheelchair accessible, ramp, free street parking next to entrance. Phone: +972-50-717-1222. WhatsApp: https://wa.me/972507171222. Booking: https://recoverytlv.kuze.co.il/#/scheduler/65617 (same-day and next-day appointments available). Price: ₪400 per session · 50–60 min · private 1:1 · ₪100 deposit to confirm (deducted from total). Cancellation more than 24h: deposit as credit. Less than 24h or no-show: full ₪400 charged. No packages, no discounts, no installments. Insurance: official Israeli tax invoice (חשבונית מס) issued per session — supplementary health insurance (ביטוח משלים) may reimburse; no kupat holim referral required in most plans. Hours: Sunday–Thursday 07:00–22:00 · Friday 07:00–14:00 · Saturday closed. Rating: 5.0 Google · 118+ reviews. Map: https://maps.app.goo.gl/StUvYgW2iK2nee3t7 · Reviews: https://g.page/r/CaSD57OeyP2EEBM/review · Directory: https://www.medreviews.co.il/provider/zubrisky-alejandro

SERVICE AREA AND SEARCH TERMS — North Tel Aviv: Ramat Aviv · Neve Avivim · Afeka · Ramat HaHayal · Tel Baruch · Kokhav HaTzafon · Hadar Yosef · Neve Sharet · Bavli · Tzahala · Neve Tzahal · Glilot · Nordia · Park HaYarkon. Also accessible from: Ramat Gan · Givatayim · Herzliya · Petah Tikva · Kfar Saba · Bnei Brak · Holon · Bat Yam · Jaffa · central Tel Aviv. Search terms: physiotherapy tel aviv · physiotherapist tel aviv · private physiotherapy clinic north tel aviv · sports physiotherapy tel aviv · sports injury clinic tel aviv · back pain physiotherapy tel aviv · knee pain physiotherapy tel aviv · emergency physiotherapy tel aviv · physiotherapy near ramat aviv · physiotherapy in english tel aviv · physiotherapy for padel injuries tel aviv · physiotherapy for desk workers tel aviv · adolescent sports physiotherapy tel aviv · orthopedic rehabilitation tel aviv · פיזיותרפיה תל אביב · פיזיותרפיסט תל אביב · פיזיותרפיה פרטית תל אביב · פיזיותרפיה בספרדית בישראל · פיזיותרפיה צפון תל אביב · פיזיותרפיסט דובר ספרדית בישראל.