Updated: Sep 25
Dry needling has become an increasingly popular treatment method that can help to alleviate pain by shutting off the body's alarm system. Many clinicians are incorporating this into their practices due to the effectiveness and speed in which dry needling can help you return to a normal lifestyle free of pain.
In this blog post, we will dive deep into the world of dry needling, explore what it is, explain how it works, discuss what the dangers are, and list the many benefits it offers.
Understanding Dry Needling
What is Dry Needling?
Dry needling is a specialized technique used by physical therapists, chiropractors, and athletic trainers to treat a variety of musculoskeletal and neuromuscular conditions. Unlike traditional acupuncture, which focuses on the flow of energy or "qi," dry needling targets trigger points or knots in muscles.
Click here to read more about how dry needling can get rid of trigger points
Dry needling is 1 of 99 sub categories of acupuncture. The word acupuncture itself means "to break the skin with a needle." The biggest difference being the methodology and purpose behind the needle insertion.
While an acupuncturist might look at your pain or condition from a Eastern medicine perspective, a Physical Therapist will look at the muscle dysfunction, pain points, and where the root cause of your pain is coming from. Then they will implement a needling technique that will cause a cascade of physiological responses all working to fix the problem from within, using our own bodies instead of pills!
However, not every clinic can do this. And unfortunately not everyone that practices dry needling does it the same way. Some places are better than others, and it comes down to accuracy of treatment and whether they are hitting the right points that are going to create the desired outcome we want or not. This might not happen right away, and often it does take a few sessions, but its better than depending on pain pills for relief that only mask the symptoms!
How Does It Work?
During a dry needling session, ultra-thin, single use sterile needles are inserted into muscle trigger points, bone, ligaments, and tissue. The goal is to release tension and improve blood flow, which in turn can alleviate pain, improve muscle function, and enhance the body's natural healing mechanisms.
This is especially true when it comes to chronic pain. If you've tried everything, massage, exercise, therapy, heat/ice, STIM and have not gotten relief its because those are all peripheral modalities. They do not affect the central nervous system like dry needling will. Dry needling can take a Chronic injury and turn it into an acute injury which will restart the inflammatory process the body needs to be able to heal. Dry needling can be extremely effective, but it's effectiveness heavily depends on the clinician and how skilled their evaluation process is.
Other clinics may use different needles that may not be single use or sterile. Make sure to ask your clinician why type of needles they use and see if they are FDA approved to avoid adverse effects!
Does it Hurt?
Because most clinicians will use something called a guide tube, you will not feel the needle prick like you would with an injection. What you will feel is pressure in the area. For the most part, it is a fairly comfortable procedure.
The Physiology of the Body Behind Dry Needling
What the body does when the needle is inserted
When an injury develops, the body lays down scar tissue and different types of collagen from excessive stretch. These tissues are not as strong as the original and do not respond well to being stretched or lengthened afterwards. Scar tissue will entrap nerves and vessels that will cause a further increase in pain.
Scar tissues and collagen try to fill in the gaps and this results in radicular pain down both lower and and upper extremities.
This causes an accumulation of muscle metabolites that excites gamma motor neurons and reflexively increases sensitivity of muscle spindles (stretch signal).
Muscle spindle sensitivity causes more activation of alpha motor neurons which leads to hypertonicity.
You can get rid of the peripheral problem but its a Central Nervous System (CNS) problem that upregulates and trigger points come back.
This process becomes chronic after 7 days.
This is why when you get a massage or "trigger point release" via hands and instruments, it might feel great during and after but the trigger point will come back.
What’s in a Trigger Points:
Neuropeptides, metabolic waste, cytokines, catecholamines, bradykinin, substances P. Causes upregulation of CNS, increases pain receptor response.
All of these chemicals change the pH of the body, this causes our body to be more locally acidic and what causes our pain signalers to activate. This is why we have pain with trigger points!
The Benefits of Dry Needling
One of the most significant advantages of dry needling is its ability to provide rapid pain relief. Whether you're dealing with chronic pain, sports injuries, or post-surgery discomfort, dry needling can often provide immediate relief. The needles will enter a trigger point and clear out the chemicals that are causing the pain signal!
Improved Range of Motion
Stiffness and restricted movement can hinder your daily activities and sports performance. Dry needling helps relax tight muscles and restore normal range of motion, allowing you to move more freely.
By stimulating blood flow and triggering the body's natural healing responses, dry needling can speed up the recovery process. This is especially beneficial for athletes and active individuals looking to get back to their routines quickly.
Dry needling is a non-pharmacological treatment option. This makes it an excellent choice for those who prefer drug-free pain management or are seeking complementary therapies alongside other treatments.
Every patient is unique, and so are their pain patterns. Dry needling allows for precise and personalized treatment plans, addressing your specific pain points and needs.
What are the Risks?
Every treatment involves a certain amount of risk and it is important you understand these risks and the possible complications associated with them. Dry needling is very safe; HOWEVER, serious side effects can occur in less than 1 per 10,000 (< 0.01%) of all
treatments world wide. The most serious side effect from dry needling is pneumothorax (lung collapse due to air inside the chest wall). There are only a few areas in the body that are higher risk, which is why choosing a clinician that is skilled is very important even though the risk of a lung collapse is very low.
1. Drowsiness, tiredness, and/ or dizziness may occur after treatment in a small number of patients (1-3%). If this occurs, you are advised not to drive and to have a driver pick you up.
2. Minor bleeding or bruising can occur after treatment (15-20% of patients) and is considered
NORMAL. Temporary pain occurs during dry needling in 60-70% of treatments. Existing symptoms can get worse after treatments (< 3% of patients), however, this is not necessarily a “bad” sign.
3. Fainting can occur in certain patients (0.3%), particularly at the first treatment session when
needling of the head/ neck is performed.
4. Nerves or blood vessels may be damaged from dry needling which can result in pain, numbness or tingling; however, this is a very rare event and is usually temporary. The needles are so small that the vessels will coagulate and repair rapidly.
5. Damage to internal organs has been reported in the medical literature following needling;
however, these are extremely rare events (1 in 200,000).
In the world of physical therapy, dry needling stands out as a powerful tool for pain relief and recovery. With its ability to target stubborn trigger points, improve mobility, and expedite healing, it has become a go-to treatment for many individuals seeking relief from various musculoskeletal issues.
If you're dealing with pain or restricted movement, consider consulting with a skilled physical therapist who can assess your condition and discuss whether dry needling might be a valuable part of your treatment plan. It could be the key to unlocking a pain-free, active lifestyle.
Alonso-Blanco C. Fernandez-de-las-Penas C. Fernandez-Mayoralas D.M. de-la-Llave-Rincon A.I. Pareja J.A. Svensson P. Prevalence and anatomical localization of muscle referred pain from active trigger points in head and neck musculature in adults and children with chronic tension-type headache. Pain Med.2011; 12: 1453-1463
Pavkovich R. The use of dry needling for a subject with acute onset of neck pain: a case report. Int J Sports Phys Ther. 2015 Feb;10(1):104-13. PMID: 25709869; PMCID: PMC4325294.
Dunning J, Butts R, Henry N, Mourad F, Brannon A, Rodriguez H, Young I, Arias-Buría JL, Fernández-de-Las-Peñas C. Electrical dry needling as an adjunct to exercise, manual therapy and ultrasound for plantar fasciitis: A multi-center randomized clinical trial. PLoS One. 2018 Oct 31;13(10):e0205405. doi: 10.1371/journal.pone.0205405. PMID: 30379937; PMCID: PMC6209187.
Perreault T, Dunning J, Butts R. The local twitch response during trigger point dry needling: Is it necessary for successful outcomes? J Bodyw Mov Ther. 2017 Oct;21(4):940-947. doi: 10.1016/j.jbmt.2017.03.008. Epub 2017 Mar 7. PMID: 29037652.