10 Questions about Dry Needling

Dry needling is a practice most used by physical therapists as a modality to assist in the treatment of musculoskeletal pain. It is becoming increasingly popular, well because, it is very effective if performed correctly in the appropriate situation.

I perform trigger point dry needling with some of my patients and have found it to be one of the most effective tools in the toolbox to help improve range of motion and decrease pain. When I bring up the idea of dry needling to a patient, the most common question asked is: What is it?

1.       What is Dry Needling?  

 Dry needling is a Western medicine technique using a thin solid filament needle to treat musculoskeletal pain. The needle is inserted into a trigger point (think of a knot) to elicit a twitch response which results in decreased pain and improves dysfunction of the tissue.

2.       What is a trigger point?

There are 2 types of trigger points in our bodies: Active and Latent trigger points. Latent trigger points are those classic knots that sit right above our shoulder blades and always feel good when it’s being massaged. Latent trigger points are local to that specific knot. When compression is put onto the knot, it feels good to be massaged but does not cause pain anywhere else in the body. Active trigger points are an entirely different beast.  Active trigger points are when the myofascial dysfunction is causing referred pain. Have you ever had someone massage your shoulder and then you feel a sharp pain jolt to the back of your head? That’s an active trigger point. Below is an example of a referral pattern of one of my favorite muscles to dry needle.

This image is showing that if there is an active trigger point at the location of the “x”, it could be causing referred pain to the side and front of the shoulder as well as down the arm.

3.       Is Dry needling the same thing as acupuncture?

I get asked this question a lot and I always say the same thing. I don’t perform acupuncture and quite honestly, I know nothing about acupuncture so I can’t speak on it nor am I the one to ask what it is. What I do know is that dry needling is performed specifically to the area of dysfunction and the needle is inserted deep enough that it penetrates the muscle. Dry needling relies heavily on the practitioner’s understanding of the skeletal and neural anatomy of the body and is always performed after there has been a thorough examination and evaluation of the presenting pain or dysfunction in the body.

4.       How does dry needling help my pain?

Speaking specifically when dry needling a muscle, the goal is to elicit a twitch response. A twitch response is a reflexive response as the muscle involuntarily twitches when the needle penetrates a taut band of tissue or an area of dysfunction. This twitch then results in a physiological process in which the body will release inflammatory chemicals and return adequate blood flow to the area. 

5.       What areas of the body can dry needling treat? 

Dry needling can help with all the following pains and injuries:

·       Headaches

·       Neck and Shoulder blade pain

·       Sciatica

·       Low back pain

·       Shoulder injuries

·       Tennis and Golfer’s Elbow

·       Achilles tendinopathy

·       Hip and knee pain

·       Plantar fasciitis

·       Everyday aches and pains

6.     Does Dry needling hurt?

After needling over hundreds and hundreds of patients, I can say that it is a completely different experience for each person. The irritability of your symptoms, the area of your body, the amount of trigger points, and your pain tolerance will dictate how much it can hurt. Patients rarely feel the needle being inserted. What you will feel is when the needle hits a trigger point. This can feel like a deep achy spasm for most people, but again it is often described differently by each person. There’s no science to back this, but elderly females seem to have the highest tolerance and my young male athletes often squirm the most

7.     What to expect after the needling session is over?

Again, the experience post-needling is always different. I always tell patients beforehand that they can expect soreness in the area that we need. The level of soreness can last from minutes to a couple of days. Again, it just depends. Approximately 24-48 hours after the needling is when you can judge how much it helped relieve your pain, often even sooner. If you are fearful of the soreness impacting your job or athletic performance, there usually are some tactics to implement such as decreasing the amount of needling and the style of needling to help combat the soreness. Stretching and drinking water always helps.

8.     How long does a session of needling last?

Again, depending on the location and intensity of the trigger points can dictate the length of each session.  Also, how many different areas that we needle in one session can dictate how many minutes. There are also 2 different approaches I will use: pistoning and electrical stimulation. The pistoning method can be as short as a couple of minutes while the electrical stimulation calls for a longer duration of approximately 15 minutes.

9.     Okay, so I was dry needled, and my pain is gone or is better. Am I fixed?

I have had instances where I needled someone for 4 minutes and it has changed their lives forever. Sometimes it could take a handful of sessions. For the needling session to be most effective it must always be followed by exercise or training. As a standalone treatment, needling is never as effective. After a round of needling, I like to load the tissue and instruct in a stretching/strengthening program. This allows us to get to the root cause of what caused the dysfunction in the first place.

10.  This sounds like it would help me, now what?

Let’s chat! Shoot me a text, email, or DM on social media and let’s find out if you would be a good fit. Phone: 920-372-2606. Email: ryan@resilience-ptperformance.com

If you have any further questions never hesitate to reach out!

Thanks for reading!

Dr. Ryan