Dry Needling Therapy


Dry needling is a treatment that involves a very thin needle being pushed through the skin in order to stimulate a trigger point. This form of alternative therapy is used to release tight muscle bands that are associated with trigger point, or hard “knots” within a muscle that can cause pain over a large area.


Sometimes these trigger points (or even muscle spasms) can make it difficult to perform everyday tasks because there is pain every time the area is touched, and the pain can even radiate to nearby areas of the body.

Dry needling is also different than acupuncture, which is intended to unblock energy meridians and help create balance within the bodily system. While acupuncture focuses on addressing the flow of energy around the body and bodily organs, dry needling focuses on stimulating a specific trigger point that is leading to pain and disability.


The researchers found that dry needling can be an effective means of pain relief when dealing with myofascial pain syndrome, or the presence of painful trigger points and muscles. When this technique is used by a physical therapist, it serves as a beneficial treatment, especially when used in combination with other techniques such as exercise.


Myofascial trigger points are a common type of pain. The word mayofascial means muscle tissue (myo) and the connective tissue in and around it (fascial). These trigger points are usually the result of a muscle injury, such as common running injuries or repetitive strain. They are painful when pressed on and can create pain in another area as well, which is called referred pain.


For example, trigger points in the muscles of the shoulder, neck and face are a common source of headaches because the trigger point refers pain to the head. According to research published in Current Pain and Headache Reports, muscle overtraining or direct trauma to the muscle can lead to the development of trigger points.


Trigger points can develop during occupational, recreational or sports activities when muscle use exceeds muscle capacity and normal recovery is disturbed. Dry needling differs from other types of physical therapy because it focuses on stimulating these trigger points and releasing the tension in order to alleviate pain.


How Does Dry Needling Work?


The solid filament needle used in dry needling allows the physical therapist to target tissues that are not manually pal palace, such as the subscapularis, iliacus and lateral pterygoid muscles.

Here are the basic steps of deep dry needling therapy:


1.: When using dry needling techniques for the treatment of trigger points, the physical therapist will palpate the target muscle for a taut band (or area of tense muscles) and identify the hyperirritable spot, thereby confirming the trigger point that needs to be treated.


2.: The needle is typically in a tube and it is fixed with the non-needling hand against the trigger point using a pincer grip or flat palpation depending on the location and orientation of the muscle. A palpation is when the physical therapist feels with her fingers or hands to pinpoint areas of tenderness. With the needling hand, the needle is gently loosened from the tube and the top of the needle is tapped or flicked by the physical therapist, allowing the needle to penetrate the skin.


3.: With deep dry needling, the needle is guided toward the trigger point until the physical therapist feels resistance or notices that the patient has a local twitch response. A local twitch response is a spinal cord reflex that creates an involuntary contraction that can be triggered by a snapping palpitation or penetration with a needle. Research shows that the local twitch response is the result of an alleviation or mitigation of some sort. This can be due to a release of immune system related chemicals, inflammation or even spontaneous electrical activity. When the patient has an involuntary twitch response, that suggests that the needle has hit the right spot.


4.: When the needle has located the trigger point, as suggested by the local twitch response, the physical therapist will focus on this specific area or other neighboring areas by drawing the needle back toward the layer of tissue directly under the skin without taking it out of the skin.


5.: The needle will then be redirected toward the remaining trigger points until local twitch responses have stopped or the patient can no longer tolerate the needling at that site.


6.: When the needle is withdrawn from the skin, pressure is then applied directly to the skin over the insertion in order to aid in the prevention of possible swelling or soreness.
During superficial dry needling therapy, the needle is placed just slightly into a muscle in the vicinity of a trigger point, but the local twitch response is not induced. The needle will be kept in place for about 30 seconds and then withdrawn. If the trigger point still appears to be sensitive after the first round, the needle will be placed in the same area again for 2 minutes.


With superficial dry needling, the physical therapist will try to alleviate trigger point sensitivity with these shorter intervals of therapy, repeating this process until he/she notices a difference. Superficial dry needling is the chosen technique for patients who cannot tolerate deep dry needling or who cramp or become stiff easily.


What is Dry Needling Able to Treat?


Dry needling involves using a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular and connective tissues in order to relieve pain and movement impairments.
According to the American Physical Therapy Association, trigger points have been identified in numerous diagnoses, including:
• migraines
• tension-type headaches
• carpal tunnel
• computer-related disorders
• whiplash associated disorders
• spinal dysfunction
• pelvic pain and other urologic syndromes
• post-herpetic neuralgia
• complex regional pain syndrome
• nocturnal cramps
• phantom pain
• tendonitis
• disk pathology
• joint dysfunction
This alternative therapy is also used to treat dysfunctions in skeletal muscle, fascia and connective tissue. It reduces and restores impairments of body structure and function, leading to improved activity and participation.