What is Dry Needling?

Dry needling is a treatment technique performed by trained physical therapists to assist with the treatment and recovery of various musculoskeletal injuries.  The treatment uses a very thin, solid filament needle(“dry” term meaning no medication on the needle and no “injection” from the use of the needle) that is placed directly into muscular trigger points.

How Does Dry Needling Work?

A trigger point is a localized, hyper-irritable spot in a taut band or knot of a muscle.  These muscle trigger points play a role in producing and maintaining the pain cycle.  Trigger points can alter muscle performance, alter a joint’s range of motion, as well as generate pain and referred pain (pain to other areas of the body).  During dry needling, the goal is to create a local twitch response, a spontaneous brisk contraction of the taut band, to stimulate and deactivate the trigger point.  Dry needling promotes healing at the area by promoting local inflammation and reducing the spontaneous muscle firing at the site of the trigger point.  This allows the muscle to relax, enhances the joint range of motion, restores strength, decreases pain, and ultimately improves function.

Photos below portray Alex Engelken, DPT, using dry needling treatment to the upper trapezius in a patient with chronic neck pain.

           

 

One important thing to remember about this treatment is that it is used in conjunction with other physical therapy treatments, based on each individual’s treatment plan and goals.  Other treatments may include other manual therapies, modalities, and most importantly progressive exercises, including a daily home exercise program in order to maintain the long term benefits of the treatment.

What Types of Problems Can Be Treated with Dry Needling?

Dry needling can be a highly effective treatment for chronic muscle pain, overuse, and repetitive sports injuries.  Conditions that may benefit from dry needling include:

  • Low back and neck pain with and without radiculopathy
  • Shoulder and arm pain, tendonitis, carpal tunnel, shoulder impingement, joint restrictions, and frozen shoulder
  • Hip and leg pain, sciatica, piriformis syndrome, muscle strain, tendonitis, trochanteric bursitis, iliotibial band syndrome, patellar tendonitis, foot and ankle sprain, Achilles tendonitis, plantar fasciitis
  • Chronic tension headaches

Is Dry Needling the Same as Acupuncture?

Licensed physical therapists in a growing number of states, including Iowa, can use dry needling under the scope of their practice.  Physical therapists at RHSHC are not licensed acupuncturists and do not practice acupuncture.  Traditional Chinese medicine typically explains acupuncture as a technique where needles are inserted through skin at strategic points on the body.  Acupuncture is a technique to balance the flow of energy (known as qi or chi), believed to flow through pathways (meridians) in your body.  The goal of acupuncture is to place needles along these meridians to re-balance your energy flow, and thus alleviate pain, stress, and tension.  In contrast to most schools of acupuncture, dry needling is strictly based on Western medicine principles and research, where needles are inserted directly into specific trigger points of muscles.  At RHSHC, only therapists with specialty training and/or certification perform this technique.

Is Dry Needling Treatment Painful?

Most patients do not feel the insertion of the needle, as the needle is very thin.  The “local twitch response” elicits a very brief, somewhat uncomfortable response.  Patients all describe this sensation differently, however, it is often described as a deep cramping sensation.  Again, the therapeutic response occurs with the elicitation of “local twitch responses”, which is the desirable reaction to dry needling treatment.

What Side Effects Can I Expect After Dry Needling?

Most patients report soreness following dry needling treatment.  The soreness is described as muscle achiness over the area treated and occasionally into the areas of referred symptoms.  Typically, the soreness lasts between a few hours up to 1-2 days following the treatment.

What Should I Do After Having a Dry Needling Treatment?

Recommendations vary depending on the amount of soreness you have and on the individual response to the treatment.  Recommendations may include applying heat or ice over the area, occasionally modification of activities, and almost always include gentle stretches and exercises prescribed by your therapist.

How Long Does It Take For Dry Needling Treatment to Work?

Each person responds differently to physical therapy treatments.  Typically, several treatments are required until positive results are achieved.  Dry needling often requires a cumulative response to achieve a certain threshold to disturb the pain cycle.

For more information about dry needling, call the Department of Rehabilitation at RHSHC at 563-547-6361.

Alex Engelken is a Doctor of Physical Therapy and has completed an advanced level certification process in dry needling.