Dry needling is one of the many manual therapy techniques being used by some physical therapists as well as chiropractors and athletic trainers to help patients improve their pain and mobility.
Though the needles used for dry needling are the same as those used for acupuncture, dry needling is different from acupuncture! This is something we make sure to make clear to patients; we are not acupuncturists and these two treatments have different methods, indications, and results.
Traditional schooling completed to receive a Doctorate of Physical Therapy involves significant education regarding human anatomy and the musculoskeletal, nervous, and cardiopulmonary systems to ensure that DPTs are highly trained in identifying and treating a variety of conditions/diseases. Dry needling training occurs outside of/in addition to what is covered in physical therapy schooling; in the state of Massachusetts physical therapists must complete 24 hours of in-person dry needling coursework in order to perform this intervention in the clinic. Our physical therapists have completed beyond the required 24 hours of coursework, through the American Academy of Manipulative Therapy and Structure & Function Education.
Keep reading for more information on what dry needling is, how it is used by physical therapists, and what to expect with this treatment!
First, what is a dry needle?
Dry basically just means the needle does not contain any fluid/medication, like the needles used when giving/receiving Botox, cortisone, or a vaccine. The needles are thin monofilaments; they don’t leave a mark on the skin, and there’s no need for a bandaid after, like with some injections! The needles are sterile, made of medical-grade stainless steel, and are disposed of after each treatment into a sharps container.
How is this used by physical therapists?
Dry needling is usually used by physical therapists as a way to treat pain and mobility limitations; target tissues usually include muscles, ligaments, tendons, and scar tissue. Once a needle is inserted, we can manipulate it in different ways - in some spots we may move it around to try to get the muscle to twitch, twist the needle, or attach it to electrical stimulation. Most of the time, we leave the needles in place for about 10 minutes before removing them and discarding them. Here at Core, if dry needling seems like it would be beneficial for a patient and the patient consents to this treatment, we will use it as part of our manual therapy during our usual 60-minute treatment sessions.
What does it do?
Inserting a needle through the skin stimulates nerves/nerve endings, muscular tissue, and connective tissue. The presence of a needle in muscle tissue can reduce pain by stimulating blood flow. It can also help reduce muscle tightness associated with trigger points or “knots” in a muscle; in those cases some of the muscle fibers can basically be stuck in a contracted, tightened state even when they are supposed to be relaxed, and the needle can help stimulate those fibers to unwind and relax.
This is thought to be why sometimes when you insert a needle into a tight or tender point in a muscle, often you’ll feel a twitch from stimulating those muscle fibers, and then ideally a release as they relax after! When we do the things I mentioned above, like twist a needle or move it under the skin, we’re trying to stimulate as many nerve endings within a muscle that we can; adding electrical stimulation can also reduce soreness during and after treatment.
Does it hurt?
Honestly, yes - to varying degrees. When the needle is inserted it can feel like a prick or pinch, such as with a finger prick, but sometimes after this initial pinch wears off, a patient doesn’t feel the needle much at all. Other times, often when we hit a particularly sensitive point in a muscle, it will feel quite sore in the area surrounding the needle - this is okay and should get less sensitive over time as the tissue relaxes. The goal is that after this part of treatment, the affected body part doesn’t feel as painful and you are able to move a bit easier. It is normal to be sore afterwards for up to 48 hours.
What kinds of conditions is dry needling used for?
Dry needling is used for a wide variety of conditions/diagnoses seen in physical therapy. Some conditions where it has been found to be particularly useful include: headaches, TMJ dysfunction/jaw pain, rotator cuff tendonitis, tennis elbow, knee osteoarthritis, and plantar fasciitis.
How is this different from acupuncture?
Acupuncture is based in ancient Chinese medicine and restoring the flow of energy (Qi) within the body. While dry needling usually places needles according to trigger points in a muscle or other anatomical landmarks (such as tendons, bones, and nerves), acupuncture points lie in accordance to meridians, the pathway along which Qi flows.
Acupuncture tends to be more of a total-body experience than dry needling, with needles placed across the body according to these meridians, and the needles are often placed more shallow than with dry needling. The needles are often left in place longer with acupuncture, such as 45-60 minutes. Acupuncture is commonly cited as being helpful in managing stress, nausea caused by chemotherapy, IBS, menstrual pain, to name a few conditions. It is common at this point for individuals to have to obtain a Master of Acupuncture degree before taking a licensure exam in order to legally practice acupuncture. There are certainly practitioners who are both physical therapists and licensed acupuncturists, but this is a bit more common outside of the US.
If you’re a current patient who would like to try it, talk to your physical therapist about if it may be appropriate for you. If you’ve had dry needling performed before and are on the search for practice that offers this, look no further!
For more information on dry needling and acupuncture, check out these links below: