Dry Needling

Overview

Dry needling is a therapeutic technique employed by acupuncturists, physical therapists, and other healthcare providers to address musculoskeletal pain and movement issues. As part of a comprehensive pain management plan, practitioners use thin, sharp needles to target myofascial trigger points—knots in muscles wrapped in thin connective tissue known as fascia. By inserting needles into these trigger points, dry needling aims to alleviate muscle tightness, enhance blood flow, and reduce both local and referred pain. This “dry” technique does not involve injecting any medication into the body, distinguishing it from trigger point injections administered by physicians.

Reasons for undergoing the procedure

When muscles undergo excessive use, they can enter a state of energy depletion, leading to reduced blood supply and insufficient delivery of oxygen and nutrients to muscle fibers. This can result in the formation of trigger points, causing sensitivity and pain. Dry needling addresses this issue by using needles to stimulate trigger points, promoting a restoration of normal blood supply, eliminating acidic byproducts, and relieving tension. The process can also activate nerve fibers, prompting the release of endorphins, the body’s natural pain relievers. While some individuals may experience immediate improvement in pain and mobility after a session, others may need multiple sessions for optimal results.

Dry needling has demonstrated potential in relieving pain and improving range of motion for various conditions, including:

• Migraines and tension-type headaches.
• Joint problems.
• Repetitive motion disorders like carpal tunnel syndrome.
• Disk-related issues.
• Pelvic pain.
• Whiplash.
• Jaw and mouth issues such as temporomandibular joint (TMJ) disorders.
• Phantom limb pain.
• Tendonitis.
• Night cramps.
• Spinal concerns.
• Postherpetic neuralgia, a complication arising from shingles.

Risks

Dry needling commonly causes soreness during and after treatment, with minor side effects such as stiffness, bruising, fainting, and fatigue. There’s a low risk of infection, so it’s crucial to ensure your provider is properly trained. Serious side effects like bleeding or a collapsed lung (pneumothorax) are extremely rare but require immediate attention. If any unusual symptoms, such as shortness of breath, occur, contact your provider or seek medical help promptly.

Before the procedure

Before undergoing dry needling treatment, your provider will review your medical history and conduct a physical examination to assess your suitability for the procedure. If deemed a suitable candidate, your provider will explain the treatment process, addressing any queries you may have. On the treatment day, it is recommended to wear comfortable, loose clothing that allows easy access to the treatment area; alternatively, a gown or covering will be provided. You will be led to a private exam room or a designated section with curtains, where you’ll adjust your clothing as needed, and your provider will position you appropriately for the dry needling treatment.

During the procedure

To begin the procedure, the treatment area will be sterilized, and a single-use, sterile, disposable needle will be prepared. The practitioner will then palpate the area with one hand to locate the trigger point, while the other hand holds the needle within a plastic guide tube. This tube aids in accurately placing the needle with one-handed precision.

With a gentle tap, the needle will be inserted into the top layer of the skin (epidermis), and the guide tube will be discarded. Various dry-needling techniques may be employed:

• Superficial technique: The needle is inserted 5 to 10 millimeters into the subcutaneous tissue above the trigger point.
• Deep technique: The needle is inserted beyond the subcutaneous tissue, penetrating deep into the muscle to reach the trigger point.

The duration the needle remains in place can vary, ranging from as short as two seconds to as long as 20 minutes. The pistoning technique, involving rapid up-and-down movements of the needle through the tissue, may also be utilized.

During the initial treatment, practitioners typically use one to two needles, gradually increasing based on the patient’s response. For specific conditions, such as back treatment, up to 10 to 15 needles may be employed along the spine.

Throughout the procedure, patients may experience normal sensations such as muscle soreness or twitching, indicating a positive response to the treatment.

After the procedure

Following your dry needling session, your provider will carefully remove the needles and inspect your skin for any reactions, disposing of the needles in a designated medical sharps container. Afterward, you’ll be advised to rise slowly, with the option to sit and rest if you feel dizzy. It’s recommended to stay hydrated by drinking plenty of water post-treatment. It’s normal to experience increased muscle soreness for 24 to 36 hours, and though bruising near the treated area may occur and last up to a week, maintaining movement is essential.

Outcome

Dry needling is generally considered a safe and often highly effective procedure for individuals with specific musculoskeletal disorders. Many people have reported significant improvements in their quality of life after undergoing this treatment. However, it is important to consult with your doctor before starting any treatment. Despite being relatively painless, dry needling is an invasive procedure, and your doctor may recommend exploring more conservative treatment options first. Prioritize discussing your condition with a medical professional to determine the most suitable course of action.