dry needling


What is Dry Needling?

Dry needling is an intervention that can be used as a treatment technique called Trigger Point Dry Needling (TDN), Functional Dry Needling (FDN), or Intramuscular Stimulation (IMS), that utilizes thin, solid filament needles to deactivate and desensitize trigger points in muscles. There is no injectable solution and the needle used is typically very thin. Myofascial trigger points are "knots" in muscles that can contribute to pain, decreased flexibility, and inhibition of proper muscle function. Dry needling is an effective and efficient method of releasing trigger points, especially when other manual techniques are unable to fully release as many trigger points directly.


Is Dry Needling the same as Acupuncture?

No - the only similarity to acupuncture is the the use of a thin, solid filament needle. The theory and methods of how the needle is utilized is different. Traditional Acupuncture uses needles to stimulate certain acupuncture points, called meridians, mapped throughout the body to promote health and restore "chi" and "energetic balance" throughout the body. Acupuncture is just one aspect of Traditional Chinese Medicine that uses a variety of Chinese medicine assessment methods. Dry needling is based on anatomy and neurophysiology where needles are used to deactivate and release altered or dysfunctional tissues in order to improve and restore function. Dry needling applies its methods to western medical reasoning utilizing anatomy and neurophysiology as its basis and not traditional Chinese medicine. In dry needling, the needle is simply used a tool to mechanically alter dysfunctional tissues causing a functional loss and pain.

How does Dry Needling work?
Janet Travell, MD, first described trigger point injections in the early 1940s. Trigger points are primarily injected with analgesics. Over the years, it has been shown that it is not the medicine that is being injected that is providing the relief, but rather the mechanical stimulus of the needle itself. Studies have shown that trigger points injected with saline have resulted in similar therapeutic benefits as those injected with analgesics. There are a number of reasons why dry needling may work. When a needle hits a trigger point, an involuntary local twitch in the muscle is often noted and felt by the client. It has been shown that the local twitch response is the most important aspect in obtaining a successful outcome for trigger point deactivation. The local twitch response causing a strong and fast muscle contraction may mechanically disrupt the contracted nature of the trigger point. Dry needling also stimulates neuroreceptors in the body which may modulate pain signals and cause positive local biochemical changes resulting in increased circulation to promote tissue healing.

What conditions can be treated with Dry Needling?
Many orthopedic and neuromuscular conditions are attributed by muscle dysfunction and altered tissue states. Active trigger points causing pain, muscle tightness, and weakness would benefit from being treated with dry needling. Some conditions that would benefit from dry needling include, but not limited to, repetitive stress injuries, tendonitis, neck and lower back pain, headaches, rotator cuff syndromes, frozen shoulder, tennis elbow, carpal tunnel syndrome, sacroiliac joint dysfunction (SIJ), sciatica, piriformis syndrome, iliotibial band syndrome, patellofemoral pain, plantar fasciitis, and muscle strains.

Is Dry Needling painful?
The insertion of the needle is typically not painful. Usually a healthy muscle feels very little to no discomfort upon insertion of the needle. Most discomfort is felt only when the needle hits dysfunctional muscle tissue that is sensitive and shortened with active trigger points, and when the needle is being used to mechanically stimulate the dysfunctional tissue. When an active trigger point is hit with the elicitation of a local twitch response, a very brief cramping and/or deep aching sensation is often felt. Dry needling may also reproduce symptoms referred into other areas of your body and directly in the muscle needled. A local twitch response and recognizable referred pain is a good reaction as it confirms a source of dysfunction.

How will I know if Dry Needling was helpful and how long does it take to work?
There are times when decreased pain and improved mobility is immediate. Typically, it may take a few treatment sessions for a lasting positive effect depending on the chronicity and severity of the condition. The goal is restore optimal muscle function with a cumulative response in deactivating trigger points. As trigger points are deactivated, it is then critical that movement patterns specific to your goals are reeducated in order to prevent the return of unwanted stress on tissues. With each session, there are usually less active trigger points in the muscles treated previously with less discomfort on each successive treatment. 

What should I expect after the treatment?
The most common side effect is soreness in the area treated for 1-2 days. The soreness is usually tolerable for most and is alleviated with gentle stretching and heat. Easy and gentle movements, such as walking, may also help to decrease post needling stiffness and soreness. Some people also feel very tired or have the sensation of just finishing an intense workout. It is a good idea to stay well hydrated after treatment and to continue correcting faulty movement patterns causing unwanted stress to promote tissue healing.