What is Dry Needling?

WHAT IS DRY NEEDLING?

Dry needling is the insertion of single use fine filament needles into the body, specifically neuromuscular tissue, with the purpose of treating pain, trigger points, muscle soreness and restoring muscle function. 

WHAT ARE TRIGGER POINTS?

Myofascial trigger points are thought to be defined as points in the muscles that experience sharp, pinpoint pain or feelings of muscle knotting when pressed on. Patients can experience them as ‘tight bands’ of tissue and often experience referred pain , or pain that travels to an area away from the origin. 

It is unclear what causes trigger points, but some ideas proposed include:

  • Ageing

  • Injury sustained from trauma

  • Lack of exercise

  • Impaired posture

  • Muscle overuse

  • Chronic stress conditions

  • Vitamin deficiency

  • Sleep disturbance

  • Joint problems/hypo-mobility

Symptoms often caused by these painful areas include:

  • Lack of range of motion

  • Losses in strength

  • Muscle weakness or imbalance

  • Tension headaches

  • Postural instability and abnormalities

Dry needling is often suggested as a treatment to help release trigger points and decrease pain. Dry needling is a modality, that’s utilised during treatment, and is most effective when combined with therapeutic exercise and manual techniques delivered by your physiotherapist.

IS IT ACUPUNCTURE?

One of the most asked questions about dry needling: is it the same thing as acupuncture? The answer is no, but the two methods do overlap.

The filament needle tool is the same for both Acupuncture and Dry Needling, however the way it is used. differs greatly.

Acupuncture is used to treat a variety of conditions, including musculoskeletal pain, weight loss, gastrointestinal issues, headaches, and mental health related conditions.

Filament needles are usually inserted superficially (shallow) and are used to clear up ‘meridians’ (vital pathways in the body where energy flows freely). Acupuncturists also focus on local muscle twitches or free-flowing of sensation when the needles are inserted along a particular path.

Dry needling utilises the same filament needle to treat musculoskeletal conditions and painful trigger points, which are identified through direct palpation of body structures. Filament needles can be inserted either superficially or deep, depending on the structure being treated. The needles can be left in the body for a short period statically or can be manipulated either by twisting or moving the filament needle in and out quickly known as ‘coning’.

IS TREATMENT SAFE FOR YOU?

Before receiving dry needling treatment, your physiotherapist will make sure you are an appropriate candidate for treatment. and that you have been screened for any health conditions that may prevent treatment from being safe and effective. 

The most common contradictions for treatment include:

  • Metal allergy

  • Severe needle phobia

  • True lymphedema

  • Skin lesions, rashes, and spray tans

  • Blood and systemic diseases e.g. Leukaemia

  • Clotting disorders

  • Cancerous tissue

  • Inability to communicate

  • Areas of implants/prosthetic tissue

  • HIV, AIDS, or hepatitis

WHAT COMMON CONDITIONS TREATED WITH DRY NEEDLING?

There are an extensive number of musculoskeletal conditions that can be treated with dry needling in addition to other therapies.  Patients who present with pain syndromes, neuro-musculoskeletal disorders, and movement impairment disorders can all benefit from dry needling. Simple muscle tightness or muscle guarding, strains and sprains, an overworked body needing recovery, muscle activation, swelling reduction, headache management and pain modulation are all examples of clinical use of dry needling. Healed and chronic scarring from trauma and other injuries can also be treated with dry needling as well as tissues contributing to neuro-musculoskeletal dysfunction including muscle, fascia, tendon, capsule, and ligament structures.

 PROPOSED BENEFITS

Dry needling has been shown to:

  • Reduce local and systemic pain effects

  • Decrease trigger point sensitivity and pain

  • Improve range of motion in a joint

  • Promote healing and speed up the recovery process when an injury is present

  • Reduce overall pain sensitivity.

DRY NEEDLING: HOW DOES IT WORK?

Although the precise mechanisms are complex and not fully known, there are a few ways in which dry needling works without delving into too much complexity.

The release of healing agents: We have pathways in place to help us recognise sensations – pain, light touch, hot/cold etc. When our body recognises injury or tissue trauma, a cascade of healing materials is sent to that specific area to start the process of restoration. A similar process happens with dry needling: the body recognises a very small amount of insult to the tissue and kicks in the cascade of healing agents. helping to bring healthy blood flow to the area where the filament needle is inserted.

Vasodilation kicks in and our vessels are opening and there is increased blood flow to the needled area, promoting the healing process. Further, the nerve growth factor is released, assisting with nerve regeneration, and leading to decreased pain sensations, promoting the normal balance in muscle tissue.


Speak to your UPG physiotherapist to discuss the suitability of this treatment option for you.

Written by Miron Andronicos - UPG Physiotherapist


REFERENCES

Australian Society of Acupuncture Physiotherapists (ASAP, 2013) Guidelines for safe acupuncture and dry needling practice.

Dommerholt, J. (2011). Dry needling — peripheral and central considerations. The Journal of Manual & Manipulative Therapy, 19, 4, 223-227.

Dunning, J., Butts, R., Mourad, F., Young, I., Flannagan, S., & Perreault, T. (2014). Dry needling: a literature review with implications for clinical practice guidelines. Physical Therapy Reviews, 19, 4, 252-265.

Hugh MacPherson.The Journal of Alternative and Complementary Medicine.Feb 1999.47-56. 

Trigger Points. (2020). Physiopedia,. Retrieved: June 1, 2021 from https://www.physio-pedia.com/index.php?title=Trigger_Points&oldid=236993.

Zhou, K., Ma, Y., & Brogan, M. S. (2015). Dry Needling versus Acupuncture: The Ongoing Debate. Acupuncture in Medicine, 33, 6, 485-490.