Dry needling is becoming increasingly popular as a drug-free treatment for pain, yet it is not free of risk. Like any healthcare procedure, it is only as safe and effective as the healthcare professional providing the treatment. If you are considering options for a movement-related pain, the answers to these 5 questions will help put dry needling into the right context.
1. WHAT IS DRY NEEDLING? Dry needling is a skillful therapy that uses a thin, filiform needle to penetrate the skin and stimulate underlying muscular trigger points or muscular and connective tissues for the management of neuromusculoskeletal pain and movement problems. As dry needling has evolved, several various terms for the therapy have emerged. The general term, “dry needling,” includes “intramuscular stimulation,” “intramuscular manual therapy,” “functional dry needling (FDN),” and “trigger point needling.”
2. HOW DID DRY NEEDLING START? Dry needling has an odd name that differentiates it from “wet” needling for injecting medication. As early as the 1900s, physician researchers wrote about palpable tenderness in the muscles causing orthopedic problems. Through the 1930s and 1940s, researchers documented predictable pain referral patterns coming from muscular trigger points. Physicians at this time treated muscular trigger points with a hypodermic needle and injectable medication. In 1940, the father of manual medicine, Karel Lewit, MD, DSc., demonstrated how the simple insertion of a “dry” needle carried more therapeutic benefit, than the injected medication. Over time the “dry” hypodermic needle was replaced with a smaller needle that is still used today.
3. IS DRY NEEDLING LIKE ACUPUNCTURE? The only similarity between dry needling and acupuncture is the tool—a solid filament needle. Acupuncture is an excellent health system, which differs from dry needling in its assessment, applications, and intended goals.
4. IS DRY NEEDLING SAFE? Like any therapy that has an effect, there is a possibility of unintended side effects. It is important to have a discussion about the benefits, risks, and other treatment alternatives for any type of treatment. With regards to dry needling, 1–10% of people may experience needling insertion pain, muscle soreness, fatigue, or bruising. Anyone with a needle phobia, history of pneumothorax, metal allergy, vascular disease, or abnormal bleeding tendency should discuss this with their doctor performing the dry needling. In the hands of a skilled physician or therapist, dry needling can be a relatively safe and very effective treatment that follows a careful examination and diagnosis.
5. WHAT CAN BE TREATED WITH DRY NEEDLING? The majority of nerve, muscle and joint pains are secondary to a movement problem. Dry needling performed in conjunction with other manual and rehabilitative therapies is an excellent way to improve range of motion and decrease muscle or tendon pain. So, needling can be incorporated in someone’s treatment plan for the treatment of headaches, neck pain, back pain, temporomandibular joint dysfunction, shin splints, hip/groin pain, shoulder pain, and many other movement related pain.
Dry needling does a great job of deactivating muscular trigger points. These are tender knots in a muscle that can refer pain to distant body areas. For example, someone with pain radiating down the thigh to the ankle may have a trigger point at the side of their hip that is only painful to deep palpation. The brief insertion of a needle into this trigger point results in a twitch of the muscle, immediate relaxation of the trigger point, and subsequent reduction of radiating symptoms to the leg.
Dr. Brad Cole is a doctor of chiropractic with a master’s degree in rehabilitation. He has 60hrs of Functional Dry Needling post-graduate training and is certified as a Level 2 practitioner by Kinetacore. You can read more of his articles and ask questions at ColePainTherapyGroup.com and DrBradCole.com.