Sports and Orthopaedic
Therapy Services, LLC
Cutting-Edge Physical Therapy
DRY NEEDLING
What is Dry Needling?
Dry needling (DN) is a technique used by Physical Therapists, Doctors, Dentists, and Nurses to treat trigger points and other problems in skeletal muscle and fibrous tissue such as fascia and connective tissue. This technique increases circulation, stimulates the immune and repair systems and also reduces persistent pain input from the arms and legs. DN is a highly skilled intervention that uses a very thin solid needle to penetrate the skin and stimulate the underlying tissues. Advanced knowledge of anatomy is necessary to be able to needle only safe areas.
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Is Dry Needling the same as Acupuncture ?
No. The only similarity between these two interventions is the use of thin filiform needles to penetrate the skin. Acupuncture uses Traditional Chinese Medicine (TCM) theory and a different evaluation to cure diseases, promote health and restore “energetic Chi balance”. It stimulates specific acupuncture points found along energy lines called meridians.
DN is based on modern Western medicine scientific principles and research. It requires an assessment of past medical history and a comprehensive musculoskeletal evaluation. The technique treats trigger points, muscle spasm, weakness, and pain. It does not consider Meridians and Chi energy or treat disease. Many DN approaches do not even require treating an exact point. Research shows that even specific trigger points can be deactivated by needling other places in the same muscle.
DN is not a substitute for Modern Physical Therapy such as manual mobilization/manipulation, therapeutic exercises, and home programs. Often DN is done simultaneously as part of the Physical Therapy plan of care.
What are some of the Conditions that can be treated with Dry Needling?
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Neck/Back Pain and Spasm
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Shoulder Pain and Spasm
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Tennis/Golfer’s Elbows
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Hip Strains and Pain
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Knee Strains and Pain
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Achilles Tendonitis/Tendonosis
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Plantar Fasciitis and Shin Splints
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Sciatica and Carpal Tunnel
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Muscle Injuries and Ligament Sprains
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Fibromyalgia/Myofascial/Chronic Pain
What are Trigger Points?
Trigger points are very tender, reactive and irritable hard “knots” within a muscle. They can cause pain locally and in nearby areas leading to difficulty in performing everyday tasks. When a person has painful muscles and trigger points, the diagnosis is sometimes called myofascial pain syndrome. Because this is associated with sleep disorders, nervous system fatigue and hyper-sensitization may be causative factors. Trigger points are classified as “active” and “latent” i.e. inactive. Common locations are in the neck, shoulders, and lower back but they can happen in many muscles.
Does Dry Needling hurt?
The patient may or may not feel the insertion of the thin needle. There may be a brief “prick” but most insertions are painless as is the removal of the needles. Occasionally there can be a mild burning sensation or tingling. If the discomfort is disconcerting, the needle is simply removed and usually the sensation stops.
What are the risks and side effects?
All invasive procedures carry some risk. Fortunately, serious problems related to DN are very rare. They include lung puncture and infection. The most serious side effect is the puncture of the lung called a pneumothorax. To avoid this possibility only short needles are used where the lung can be accessed and/or they are angled to stay superficial. In many cases, the thoracic cage area over the lungs is just avoided.
The second serious side effect is an infection. There are no documented cases of infection due to dry needling in the literature according to the Institute of Dry Needling. Reported cases occurred only after acupuncture treatment. We follow accepted safety precautions by always using gloves and sterile single-use needles. Wiping the area to be treated with alcohol is not suggested as necessary unless the area is felt to be dirty.
Mild side effects include slight brief bleeding (< than a single drop), local bruising, 1-2 days of soreness, fatigue, and drowsiness. Bleeding and bruising are avoided by applying pressure on the needled spot.
Sources:
This information was compiled from descriptions by the American Physical Therapy Association, the Institute of Dry Needling, the Journal of Orthopedic and Sports Physical Therapy and texts on trigger points and Intramuscular dry needling.