What is Dry Needling?

Dry needling (DN) is a treatment technique for acute and chronic pain that contributes to movement impairments. During a treatment, the physical therapist will locate trigger points, or “muscle knots” that are painful when touched on the patient. Then, the therapist will insert thin filiform “dry” needles 5-10mm into these myofascial trigger points to “release” the pain.

Benefits of Dry Needling.

DN provides many possible benefits:

• reduce pain
• help release toxins
• promote healing (faster recovery)
• normalize dysfunctions
• reduce muscle tension of the motor endplates (nerve impulses at transmitted to muscles at these sites)

Other Names for Dry Needling.

Physical therapists also commonly refer to the procedure as:

• functional dry needling
• trigger point dry needling
• myofascial point dry needling

Orthopedic Institute Physical Therapist Performing Dry Needling on a Patient

Is Dry Needling Effective at Treating Pain?

Yes. A meta-analysis published in the Journal of Orthopedic and Sports Physical Therapy concluded that DN may decrease pain and increase pressure pain threshold (PPT) compared to control treatments. PPT is a test that measures deep muscular tissue sensitivity, which is the amount of pressure needed to go from a non-painful pressure sensation to a painful pressure sensation.

Orthopedic Institute Physical Therapist Discussing Dry Needling with a Patient and showing a Spine Model

Who May Benefit From This Treatment?

People of all ages, athletes, and non-athletes with musculoskeletal acute or chronic injuries may benefit from a session of treatments. DN is commonly used in the treatment of many injuries including:

• trigger points
• neck and back pain
• muscle strains
• headaches
• hip and knee pain
• hip and shoulder impingement
• bursitis
• plantar fasciitis
• fibromyalgia
• sports injuries

In addition, DN may effectively treat overuse injuries, including but not limited to tendinitis and golfer and tennis elbow.

However, there are some contraindications for this treatment method. A discussion of the current problem and past medical history should occur with a physical therapist to determine if dry needling is an appropriate and safe treatment option for you.

Why Might This Treatment Work When Other Treatments Don’t?

When massage therapy, chiropractic treatment, or traditional physical therapy techniques provide only temporary relief, it may be that the problem resides deeper in muscles that rest along the skeletal bone. DN can be a more effective and long-lasting treatment option if this is the case, as it allows the physical therapist to target muscles at all levels within the musculoskeletal system.

Orthopedic Institute Physical Therapist Demonstrating Dry Needling Location on a Spine Model

Does This Treatment Work for Everyone?

Most people benefit in the short term from DN treatments. In fact, the research suggests that not only does DN provide a statistically significant effect on functional outcomes, but at 6 to 12 months, patients also favored DN for decreasing pain. However, the same meta-study concluded that that evidence of the long-term benefit of DN is currently lacking.

How is Dry Needling Different from Acupuncture?

DN is sometimes confused with acupuncture. While acupuncture and dry needling both involve inserting tiny monofilament needles as part of the treatment, this is the only similarity between the two methods. Acupuncture has its roots in ancient Chinese medicine and attempts to restore the proper flow of energy throughout the body. With acupuncture, the physician inserts needles into points of the body along meridian lines. Acupuncture is most often used to treat chronic pain, internal ailments, digestive problems, insomnia, and stress. Sometimes these needles are left in place for 15 to 30 minutes.

DN, developed in the early 1980s, is based on modern Western medicine principles and is used to treat localized trigger points to reduce pain, improve joint mobility, improve strength, and normalize movement function. Treatment time is usually 10 to 15 minutes.

What is a Trigger Point?

An active trigger point is a taut band of skeletal muscle or “knot” that is usually hyperirritable to direct pressure. These active trigger points often “refer” pain to other body areas that the physical therapist can map into specific patterns. Active trigger points may contribute to muscle weakness and restricted range of motion. A physical therapist uses their expert knowledge of these common referral patterns and anatomy to identify specific trigger points to establish appropriateness for dry needling as an effective treatment.

What Happens During a Treatment?

Upon identifying the trigger points, the physical therapist will treat the exposed skin to establish a sterile field, to reduce the risk of complications from inserting the needles. The physical therapist will then insert a thin filiform “dry” (unmedicated) needle through the skin, directly into the identified trigger point.

Orthopedic Institute physical therapist performing dry needling on a patient.

Is the Treatment Painful?

When the needle hits the trigger point, the patient often feels a sensation of deep pressure or localized twitch response from the muscle, followed by a feeling of release or decrease in tension. To avoid any unnecessary discomfort, the physical therapist continually communicates with the patient during the treatment process to monitor for any abnormal response to treatment that may indicate the need to relocate the needle within the target area or modify the treatment depth.

The physical therapist may elect to use a pistoning technique or electric stimulation in conjunction with dry needling to elicit the desired twitch response within the muscle to provide pain relief.

How Deep do the Needles go into your Skin?

In the early 1980s, at the age of 60, Peter Baldry, an English physician, practiced and promoted acupuncture and trigger point dry needling before it was common in Western medicine, training other doctors to use the techniques and writing several textbooks. Baldry recommended inserting needles to a 5-10mm depth over myofascial trigger points (MTrP) for 30 secs. Many physical therapists use this approach to this day.

Orthopedic Institute Physical Therapist with Dry Needling Needles

How long does a Treatment take?

The total treatment time may take 10 to 15 minutes.

What do you do after a Treatment?

Dry needling is rarely a treatment given to a patient in isolation. Physical therapists will provide an exercise prescription recommendation in the form of stretching or correct movement exercises following dry needling treatment to maximize the effectiveness and longevity of the treatment benefits.

How Often Should you get a Treatment?

A typical treatment plan will call for once-a-week sessions over 2 to 3 weeks, mixed with regular physical therapy. In rare cases, patients may choose up to 6 sessions depending upon their results. 

Orthopedic Institute Physical Therapist Discussing Dry Needling with a Patient

Who can Perform a Treatment in South Dakota?

DN is an approved treatment for specially trained physical therapists in South Dakota to perform. When performing the treatment, physical therapists wear gloves and appropriate personal protective equipment (PPE). 

Call Orthopedic Institute for questions or to schedule a session at 605-977-6845.