So what is dry-needling? This is one of the most common questions that we are currently asked. Some individuals have heard of it from friends or family members that have had it done before, while others have no idea about what it is, why it is performed, or what the benefits are.
Dry needling is NOT acupuncture. Both practices utilize a thin monofilament needle to penetrate the skin to varying tissue depths, however the science behind the practices is vastly different. Acupuncture is a traditional Chinese medicine practice that utilizes meridian’s in the body to balance the flow of energy, or qi (chee). Dry needling is a practice based on knowledge of the musculoskeletal system aimed at managing injuries and pain while addressing movement dysfunction.
It is called “dry” because there is no medicine or injectate on the needles. This practice is commonly known for its use to treat trigger points, a tender or a painful area in a muscle. When a needle goes into a trigger point it generates a local twitch response. If you are into the specific science, this process clears excessive acetylcholine from the neuromuscular junction, reducing spontaneous electrical activity at the end plates, and allowing the muscle to relax, therefore, reducing pain and improving range of motion. (Think, it releases inflammatory chemicals that are built up in the muscle tissues)
While trigger point dry needling has been the predominant method, it is not the only process a therapist can utilize. Research is now showing that similar techniques of needling can target various tissues in the body. This can include anything from tendons, ligaments, scar tissue, fascia (spider web-like material that surrounds muscles, bones, organs, ect), and in the proximity of nerves/vasculature. Insertion of a needle around tendons and ligaments has been shown to increase collagen production, improve collagen remodeling/re-organization, decrease inflammation, and increase blood flow and nutrients to promote tissue healing. Similar effects have been seen with insertion in/around scars to improve tissue mobility by promoting increased fibroblastic activity and tissue re-organization. Once a needle is in place, twisting and electrical stimulation are mechanical techniques that can be applied to the needle to increase tissue stimulation and promote greater effect areas. For example, let’s say you are experiencing low back pain. Your therapist may place needles into the small segmental muscles in your low back. By adding electrical stimulation to these needles, the muscles will twitch across several levels of the spine increasing your target tissue area with fewer needles. Research has also shown that optimal results are obtained when needles are left in place for 10-30 minutes and when treatment is used in conjunction with other therapy interventions including strength training, stretching, motor control training, & manual therapy.
Diagnoses that Dry Needling has been proven to help:
– TMJ Dysfunction
– Neck pain
– Rotator Cuff tendinitis
– Golfers/Tennis Elbow
– Carpal Tunnel
– Back pain
– Sciatic Nerve pain
– Joint Pain
– IT band syndrome
– Achilles Tendinitis
– Muscle aches/pains
– And so much more!
So, now you are wondering if this is painful….
There is often a sensation of ache, muscle twitch, or pain when the needle is being inserted, but it is short-lived lasting only a few seconds. After the session is complete, you can expect muscle soreness/stiffness or an ache like you got in a good workout. This is often present for up to 24-hours following your treatment session. Movement and hydration can help flush out the soreness and reduce its duration. Side effects are typically very minimal and aside from soreness may include small bruising around the insertion site.
In conclusion, dry needling has minimal side effects and HUGE benefits in decreasing pain and stimulating the healing process. It should be used in conjunction with other therapy interventions, and not as a stand-alone treatment, in most cases. It can take several sessions to fully heal the inflamed tissues, but typically there is relief and improved function after the first session.
Written By Dr. Tamara Vead, PT, DPT, Dry Needle Cert, PCES
Dunning, J., Butts, R., Mourad, F., Young, I., Flannagan, S., & Perreault, T. (2014). Dry needling: A literature review with implications for clinical practice guidelines. Physical Therapy Reviews, 19(4), 252–265. https://doi.org/10.1179/108331913×13844245102034
Butts, R., Dunning, J., Perreault, T., Murad, F., & Grubb, M. (2016). Peripheral and spinal mechanisms of pain and dry needling mediated analgesia: A clinical resource guide for health care professionals. International Journal of Physical Medicine & Rehabilitation, 04(02). https://doi.org/10.4172/2329-9096.1000327