What Does Dry Needling Do and What Is It Used For In Physical Therapy?
Dry needling is a hands-on treatment technique utilized by physical therapists during patient care. In this blog post, we’re going to review what dry needling is, what dry needling does, and how dry needling is used in physical therapy.
What is “Dry Needling”?
Dry needling is a treatment technique used by Physical Therapists. This technique utilizes thin, solid needles and is called “dry” because there is no medication injected into the body (unlike trigger point injections or regular injections). The needles remain in your muscle for a short period - 10 seconds to many minutes - depending on the location, number of needles used, and treatment goals. Changes may be felt immediately or within 24 hours of a treatment session. Most people report maximum benefit after repeat sessions.
What Does Dry Needling Do?
Dry needling can be safely implemented by a properly trained clinician as a powerful intervention for treating many musculoskeletal and neuromuscular conditions. During a dry needling treatment, one or more thin, monofilament needles are inserted into a muscle trigger point. A trigger point is a local band of tight and irritable muscle tissue. This often emerges because of injury, overuse, or poor movement patterns. Dry needling is used to either facilitate or inhibit abnormal muscle tone and motor recruitment patterns. It can also help by increasing blood flow, decreasing myofascial pain, and reducing trigger points. To summarize, dry needling can help with the following:
Relieve pain and improve range of motion
Reduce muscle tension
Increase blood flow to the affected area
Treat myofascial trigger points - localized hypersensitive spots in a palpable taut band of muscle that can cause pain
Temporarily improve the biomechanical properties of muscle, leading to improved muscle performance
How is Dry Needling Used in Physical Therapy?
Physical Therapists have the most extensive education in neurophysiology and anatomy and our treatment techniques are aimed at the musculoskeletal and nervous systems. In addition to completing a 3-year post-graduate program and passing the physical therapy license board exam, further education and certification specific to dry needling is required. The technique of dry needling is not particularly hard to learn. Sure, we learn proper needle techniques and safety, precautions, and contraindications, but the real skill comes from using our anatomy and trigger point pain referral pattern knowledge in order to provide the safest and most effective treatment.
What Does a Pelvic Floor Physical Therapist Use Dry Needling For?
So many ways! Patients with pelvic floor dysfunction can also have pain or restriction in the muscles of the back, abdomen, hips, glutes, inner thighs, hip flexors, and upper leg muscles and dry needling can be helpful in all of these areas. In addition, some physical therapists (myself included) have had specialized training in using dry needling on the pelvic floor muscles directly, which can help with pelvic pain, pelvic myofascial pain syndrome, pudendal nerve pain, and bladder symptoms such as pain, irritation, hesitancy, and urgency. We can also help with scar tissue, such as from a cesarean birth.
Physical therapists also often use e-stim with dry needling, which stands for neuromuscular electric stimulation (NMES). The use of e-stim adds an electric current that stimulates the nerves and muscles. E-stim has been used for pain management, improved muscle recovery, muscle strength, and neuromuscular re-education and is a great adjunct to dry needling.
It can be used in a few ways. One way is using a point stimulator to stimulate current at one needlepoint. Another way is to use a unit with multiple channels that clip onto multiple needles and can stimulate them as a group.
Is Dry Needling Like Acupuncture? No!
Dry Needling is based on neurophysiology and anatomy and affects the musculoskeletal and nervous system. Acupuncture is a form of Traditional Chinese Medicine that aims to balance energy flow through meridians in your body.
Does Dry Needling Hurt? Are There Any Side Effects?
Some people feel discomfort or pain during the needling and sometimes they don’t. When inserting a needle into a trigger point, it can be painful and can cause the muscle to twitch. When electrical stimulation is used in conjunction with the dry needling, the muscle will also twitch, but this is typically not painful. People may report soreness or fatigue in the affected area post-treatment that can last for 1-24 hours. Common side effects (1-10%) include needle inersion pain, muscle soreness, muscle fatigue, or bruising.
Are there any contraindications?
These include: local infection, active tumor, inadequate training, denied patient consent, and 1st trimester of pregnancy. Most common relative contraindications/precautions include: the use of blood thinners, post-surgical (depending on where the surgery was and what is being dry needled), history of lymph node removal, and respirator illness (if getting dry needling in the lung area), needle phobia, history of pneumothorax (lung collapse), and vascular disease.
We avoid the use the dry needling as an intervention during the 1st trimester of pregnancy due to the higher risk of spontaneous miscarriage during this time period. There is no evidence to suggest that dry needling would cause a spontaneous miscarriage, however we want to protect ourselves and avoid any therapy intervention to be associated with this unfortunate adverse event. During pregnancy we also avoid dry needling the thoracolumber junction, pelvic floor musculature, and anterior abdomen.
In Summary…
Think of dry needling as a “tissue re-set” which can re-establish pain-free movement and improve muscle function. It's often paired with electrical stimulation to enhance the effects of the treatment. To get lasting benefits from dry needling, treatments are paired with exercise and other Physical Therapy treatment techniques to yield optimal outcomes. Dry needling can be a great tool for helping reduce pain and getting people back to the exercise and activities they love to do!
Are you looking to try dry needling or want to meet up to find out if this treatment option could benefit you? If you live in the greater Minneapolis, Minnesota area, my clinic is in Edina, MN. Let’s work together - contact me to learn more!
References:
Is Dry Needling Applied by Physical Therapists Effective for Pain in Musculoskeletal Conditions? A Systemic Review and Meta-Analysis. Sánchez-Infante J, Navarro-Santana MJ, Bravo-Sánchez A, Jiménez-Diaz F, Abián-Vicén J. Phys Ther. 2021 Mar 3;101(3):pzab070. doi: 10.1093/ptj/pzab070.
Acute Effects of the Dry Needling Session on Gastrocnemius Muscle Biomechanical Properties, and Perfusion with Latent Trigger Points - A Single-Blind Randomized Controlled Trial in Mixed Martial Arts Athletes. Trybulski R, Stanula A, Żebrowska A, Podleśny M, Hall B. J Sports Sci Med. 2024 Mar 1;23(1):136-146. doi: 10.52082/jssm.2024.136. eCollection 2024 Mar.
The Effectiveness of Trigger Point Dry Needling for Musculoskeletal Conditions by Physical Therapists: A Systematic Review and Meta-analysis. Gattie E, Cleland JA, Snodgrass S. J Orthop Sports Phys Ther. 2017 Mar;47(3):133-149. doi: 10.2519/jospt.2017.7096. Epub 2017 Feb 3.
Myofascial trigger points of the pelvic floor: associations with urological pain syndromes and treatment strategies including injection therapy. Moldwin RM, Fariello JY. Curr Urol Rep. 2013 Oct;14(5):409-17. doi: 10.1007/s11934-013-0360-7.
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Disclaimer: The information in this blog post is for general purposes only and is not intended to be used as medical advice, diagnosis, or treatment. Refer to your medical provider for all questions and concerns regarding your individual care.
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