The following are answers to common questions about the dry needling technique. Click the questions to read the answers.
Dry needling is an invasive procedure in which a solid monofilament needle is inserted into the skin and muscle directly at a myofascial trigger point. A myofascial trigger point consists of multiple contracture knots in muscle tissue, which is related to the production and maintenance of the pain cycle.
There are many similarities and differences between dry needling and acupuncture. Licensed physical therapists in a growing number of states in the USA use dry needling under the scope of their practice. Dry needling also falls within the scope of acupuncture practice. Physical therapists at Naperville Physical Therapy are not licensed acupuncturists and do not practice acupuncture. In contrast to most schools of acupuncture, dry needling is strictly based on Western medicine principles and research.
The exact mechanisms of dry needling are not known. There are mechanical and biochemical effects. Based on pioneering studies by Dr. Jay Shah and colleagues at the National Institutes of Health, we know that inserting a needle into trigger points can cause favorable biochemical changes, which assist in reducing pain. It is essential to elicit so-called local twitch responses which are spinal cord reflexes. Getting local twitch responses with dry needling is the first step in breaking the pain cycle.
Dry needling can be used for a variety of musculoskeletal problems. Muscles are thought to be a primary contributing factor to the symptoms. Such conditions include, but are not limited to neck, back, and shoulder pain, arm pain (tennis elbow, carpal tunnel syndrome, golfer's elbow), headache to include migraine and tension-type headaches, jaw pain, buttock pain and leg pain (sciatica, hamstring strains, calf tightness/spasms). The treatment of muscles has the greatest effect on reducing pain mechanisms in the nervous system.
Most patients do not feel the insertion of the needle. The local twitch response elicits a very brief (less than a second) painful response. Some patients described this as a little electrical shock; others feel it more like a cramping sensation. Again, the therapeutic response occurs with the elicitation of local twitch responses and that is a good and desirable reaction.
Yes, we only use sterile disposable needles.
Most patients report being sore after the procedure. The soreness is described as muscle soreness over the area treated and into the areas of referred symptoms. Typically, the soreness lasts between a few hours and two days.
Our recommendations vary depending on the amount of soreness you have and on the individual responses to treatment. Recommendations may include applying heat or ice over the area, gentle range of motion exercises to work on muscle coordination, and modifications of activities.
Typically, it takes several visits for a positive reaction to take place. Again, we are trying to cause mechanical and biochemical changes without any pharmacological means. Therefore, we are looking for a cumulative response to achieve a certain threshold after which the pain cycle is disturbed.
In the US, dry needling is a relatively new method for treating myofascial pain syndromes and not everyone is already aware of this effective modality. Feel free to inform your doctor about this treatment option. It is upon all of us to educate others about new and innovative ways to treat pain.
Dry needling is part of a manual therapy treatment program to help break the pain cycle. Once that is achieved, other treatment options are introduced.
The musculoskeletal system is under constant pressure from gravity, stress, work, etc. A regular exercise program combined with good posture can prevent many problems. If the pain comes back, "tune-ups" are recommended to treat and prevent serious injuries.
No, dry needling should only be performed by a trained and qualified health professional. Dry needling performed by a non-qualified person could lead to serious injury.