Have you ever heard of dry needling? Some of you might be wondering: What is that and what does it have to do with physical therapy? As a relatively new treatment modality in the physical therapy realm, dry needling is not exactly a household term. Today on the blog, we plan to answer questions that might come to mind when you hear “dry needling”. For example, what is it? Is it acupuncture? Does it work? Does it hurt? Is it safe?" Let’s start with some definitions. Dry needling is defined as “a procedure where a fine needle is inserted into the skin and muscle. It is aimed at myofascial trigger points (MTrP) which are hyper-irritable spots in skeletal muscle that are associated with a hypersensitive palpable nodule in a taut band" (1). A trigger point is a taut band of tissue. If you've ever had a "knot" in your back, you've likely experienced a trigger point. Dry needling helps to release the trigger point, thereby decreasing the pain associated with them, via insertion of a very small needle into the muscle. Of note, this is different than acupuncture, which is a practice involving insertion of small needles at specific points on the body, defined in eastern medical practice terms as "prime meridians”. Now you might be wondering: How does a needle fix a trigger point? After the needle is inserted into the trigger point, a "twitch response" is achieved. The twitch response is an involuntary muscular contraction that occurs when the needle hits the trigger point. In fact, physical therapists can actually feel, and sometimes see, the muscle twitch after the needle has been inserted. After the twitch response, the trigger point dissipates.
"A significant amount of research into this treatment modality lends credence to its effectiveness."
Although we hear a lot of positive feedback from patients, the science also agrees that dry needling works. A significant amount of research into this treatment modality lends credence to its effectiveness. For example, there is evidence of decreased nociceptive (painful) chemicals surrounding the trigger point after dry needling. Rest assured, this is an evidence based, well supported modality that provides a significant benefit for many patients. Let’s talk about the process from the patient perspective. The therapist will first position you to safely access the trigger point itself. Then, the needle is inserted. Unlike needles used for many medical procedures, these needles are so small that the patient does not feel them being inserted. The therapist will then move the needle in and out of the trigger point. As the twitch response happens, you might feel like your muscle is moving by itself, or involuntarily. Then, the therapist withdraws the needle, and may move on to another trigger point. Some discomfort is not uncommon during the twitch response, but patients do not feel the insertion or withdrawal of the needle. After your dry needling session, you might feel like the area is sore for up to 72 hours. Many of our patients describe the feeling as “like I just worked out that area”. Ibuprofen and Tylenol, if approved by your doctor, can often decrease this sensation. To summarize, dry needling is well tolerated by our patients with minimal pain noted during and after the procedure.
"Dry needling is indeed a safe and low risk treatment modality"
Finally, as with any treatment modality, it is imperative to address safety. Dry needling is indeed a safe and low risk treatment modality. In order to perform dry needling, providers should be professionally trained, as we are here at Tier One. Risks of the modality include bleeding, infection, or injury to the surrounding structures; however, these are extremely uncommon. If there is ever a question as to whether or not dry needling is safe for you, consultation with your doctor is important prior to participating.
If you or someone you know is suffering from trigger points or myofascial pain, dry needling might be the right modality for you. Give us a call today at 401-584-9098 to learn more and schedule an appointment.
Sources:
1. Dommerholt, J., Del Morel, O. and Grobli, C. Trigger point dry needling. The journal of manual and manipulative therapy 2006;14(4), 70-87
2. Ga H, Choi JH, Park CH, Yoon HJ. Dry needling of trigger points with and without paraspinal needling in myofascial pain syndromes in elderly patients. J Altern Complement Med. 2007; 13: 617– 624.
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