What is dry needling?  

Dry needling is a therapeutic technique in which thin, sterile needles are inserted into specific points in muscles and connective tissue to relieve pain and tension. The needles target "trigger points"—tight bands or knots in muscles that can cause pain in other parts of the body (referred pain). Dry needling is commonly used by physical therapists and other healthcare professionals to treat conditions such as musculoskeletal pain, muscle tightness, joint pain, and sports injuries.  

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Mechanism of Dry Needling  

• Trigger Points: Trigger points are sensitive, tight areas within muscle tissue that may restrict movement and cause pain in other areas. 

• Insertion and Stimulation: The insertion of needles into these points stimulates a twitch response in the muscle, which can help to relax the muscle fibers, increase blood flow, and reduce inflammation. 

 

Dry Needling vs. Acupuncture 

• Although dry needling and acupuncture both use thin needles, they differ in philosophy and application. 

• Acupuncture is rooted in traditional Chinese medicine and focuses on balancing energy (Qi) by targeting meridian points. Dry needling, however, is based on Western medical principles and anatomy, specifically focusing on trigger points and musculoskeletal pain. 

Common Conditions Treated 

• Myofascial Pain Syndrome: Chronic pain in muscles and connective tissue. 

• Sports Injuries: Relief from injuries like muscle strains, tendinitis, and ligament sprains. 

• Headaches and Migraines: Especially when related to tension in the neck or upper back. 

• Joint Pain: Including knee, shoulder, or lower back pain caused by muscular tension. 

Possible Side Effects 

• Patients may experience soreness, bruising, or minor bleeding at the needle sites. Serious complications are rare, but it’s essential to have the procedure performed by a trained, licensed professional. 

Is dry needling safe?  

Yes, dry needling is generally considered safe when performed by a trained and licensed professional. Most people experience only mild, short-term side effects, but like any medical procedure, dry needling does carry some risks and side effects.

Common Side Effects 

• Soreness: It’s common to feel soreness in the treated area, similar to post-exercise soreness. This usually lasts for 24 to 48 hours. 

• Bruising or Minor Bleeding: Small bruises or bleeding at the needle site can occur, but they typically resolve on their own. 

• Fatigue: Some people report feeling tired after a dry needling session, likely due to the release of muscular tension. 

 

Will dry needling cause bleeding?  

Yes, dry needling can cause minor bleeding, though it's usually minimal.  

Why Bleeding Occurs ?

• Puncturing Small Blood Vessels: During dry needling, a thin, filiform needle is inserted into the muscle to target trigger points. In the process, small blood vessels in the area can be punctured, leading to light bleeding. 

• Individual Variability: Factors like skin sensitivity, tissue density, and individual blood vessel distribution can make some people more prone to bleeding than others. 

How Common is Bleeding? 

• Minor Bleeding: For most people, any bleeding is generally light and stops quickly. This is more common at the surface where the needle entered. 

• Bruising: Bruising can also occur as a result of minor internal bleeding from punctured blood vessels. This is usually harmless and should resolve within a few days. 

Safety Considerations 

• Trained Professionals: Having the procedure performed by a certified practitioner helps ensure safe technique, minimizing risks of deeper bleeding. 

• Aftercare: Applying pressure and an antiseptic to the treated area afterward can further reduce bleeding and prevent infection. 

Is dry needling painful?

Dry needling can cause mild discomfort or pain, but the sensation varies widely depending on individual sensitivity, the specific area being treated, and the technique of the practitioner. Here is  what to expect:

1. Initial Sensation 

• When the needle is first inserted, you might feel a quick prick or mild pinch. For most people, this is a minor sensation, and it’s typically brief. 

2. Muscle Response or "Twitch" Sensation 

• As the needle targets trigger points or knots in the muscle, it may cause a "twitch" response, where the muscle contracts and then releases. This is usually a good sign, indicating the needle has hit the tension spot, but it can cause a quick, deep ache or mild cramp. 

3. Dull Ache or Pressure 

• Some people report a dull ache, pressure, or slight heaviness around the needle insertion site. This is usually manageable, and practitioners can adjust needle depth and technique to minimize discomfort. 

4. Post-Needling Soreness 

• After the procedure, it's common to experience mild soreness similar to the feeling after a workout. This typically fades within 24-48 hours and can often be managed with light stretching, hydration, or applying heat. 

Factors Affecting Pain Level 

• Location: Areas with less muscle or more nerve endings, like the hands or face, might feel more sensitive. 

• Experience of the Practitioner: Skilled practitioners can usually make the experience more comfortable. 

• Personal Pain Threshold: People with a lower pain tolerance may find dry needling more uncomfortable, while others may barely notice it. 

For many, the potential discomfort is often outweighed by the relief it provides for chronic pain, muscle tightness, and tension.  

Who Should Avoid Dry Needling? 

• Pregnant Women: Certain points are avoided, especially in early pregnancy, so consult a healthcare provider before treatment. 

• People with Bleeding Disorders or on Blood Thinners: These individuals may experience more bruising or bleeding and should consult with their doctor. 

Individuals with Needle Phobia or Anxiety: For those uncomfortable with needles, dry needling may not be ideal. ​

Is dry needling beneficial for me?  

Dry needling can be beneficial for many individuals, particularly those with musculoskeletal pain or muscle tightness. Here are some potential benefits that may be relevant to you as a physical therapist and someone with expertise in orthopedic conditions: 

• Pain Relief: Dry needling can help reduce pain by targeting trigger points in the muscles, which can lead to muscle relaxation and decreased pain perception. 

• Improved Range of Motion: By alleviating tightness and pain in muscles, dry needling may improve flexibility and range of motion, which can be crucial for rehabilitation. 

• Faster Recovery: Incorporating dry needling into treatment plans can potentially speed up recovery times for certain injuries or conditions. 

• Enhanced Muscle Function: It can promote better muscle function by addressing underlying issues in muscle tissue, helping to restore normal movement patterns. 

• Complementary Treatment: As a skilled practitioner, you can integrate dry needling with other modalities and techniques, enhancing the overall effectiveness of treatment. 

• Patient Outcomes: Many patients report positive outcomes from dry needling, which can increase patient satisfaction and compliance with treatment plans. 

Is dry needling evidence based?  

Yes, dry needling is evidence-based and is supported by a growing body of research, particularly for its effectiveness in reducing musculoskeletal pain and improving function. Dry needling involves the insertion of thin needles into myofascial trigger points, taut bands of muscle, or areas of musculoskeletal pain, with the goal of releasing tension, reducing pain, and improving movement. Dry needling is supported by evidence for various musculoskeletal and pain-related conditions. It’s generally most effective when used alongside other therapies, such as physical therapy, to address the underlying movement and strength issues associated with pain and dysfunction.  

1. Pain Reduction 

• Myofascial Pain Syndrome: Studies have shown that dry needling can reduce pain associated with myofascial pain syndrome by deactivating trigger points in muscles. Patients often experience relief as the trigger points are released, which can decrease pain and increase comfort. 

• Chronic Pain Conditions: Dry needling has been found effective for reducing chronic pain conditions such as neck pain, lower back pain, and temporomandibular joint (TMJ) disorders. It is often recommended as part of a comprehensive pain management approach. (We do not treat TMJ disorders at our clinic). 

2. Improvement in Range of Motion and Muscle Function 

• Flexibility and Range of Motion: Evidence suggests that dry needling can improve range of motion by releasing muscle tightness and reducing trigger point tension, which helps to restore normal muscle function. 

• Enhanced Muscle Activation: Studies show that dry needling can improve muscle activation, allowing patients to engage muscles that may have been inhibited by pain or tension. This can be particularly helpful in rehabilitation, as it facilitates better movement and coordination. 

3. Neuromuscular Re-Education 

• Central and Peripheral Mechanisms: Research supports that dry needling works through both central (brain and spinal cord) and peripheral (muscular) mechanisms. By stimulating the nervous system and reducing local muscle tension, dry needling can help reset neuromuscular patterns, making it effective for pain reduction and muscle re-education. 

• Analgesic Effects: Dry needling may trigger an analgesic effect by releasing endogenous opioids (the body's natural painkillers) and reducing local inflammation, which can help relieve pain in treated areas. 

4. Treatment for Specific Conditions 

• Tension-Type and Migraine Headaches: There is evidence that dry needling can reduce the frequency and severity of tension-type and migraine headaches, particularly when targeting trigger points in the neck and shoulder regions. 

• Plantar Fasciitis, Tennis Elbow, and Knee Pain: Studies indicate that dry needling may be effective in treating conditions like plantar fasciitis, tennis elbow, and knee osteoarthritis by targeting pain and dysfunction in affected muscles. 

• Complement to Physical Therapy: Studies often support dry needling as an adjunct to physical therapy, particularly for conditions that benefit from both pain reduction and improved muscle function. For example, combining dry needling with exercises has been shown to enhance recovery in conditions like shoulder impingement and low back pain. 

6. Safety and Clinical Guidelines 

• Clinical guidelines and position statements from organizations like the American Physical Therapy Association (APTA) and the Federation of State Boards of Physical Therapy (FSBPT) support dry needling when performed by trained practitioners. They recognize its efficacy for pain reduction and functional improvement in musculoskeletal conditions. 

Do you use new needles each time for dry needling?

Yes, in dry needling, new, sterile needles are used for each treatment session. This practice is essential to maintain safety and minimize the risk of infection. Each needle is single use, ensuring that they are not reused on different patients or even on the same patient during different sessions.