Dr. Samantha Peter, PT, DPT
What is Dry Needling (DN)?
Dry needling is a very effective treatment option in the therapist toolbox backed by evidenced-based research where an acupuncture needle is inserted directly into the skin down to the muscle to restart the healing and repair process. It’s called “dry” because no substance is being injected. After several treatments, DN can repair the involved tissue which significantly reduces or eliminates pain.
On a physiological level, DN increases blood flow to the treated area over time.
When the needles are manipulated in some way, either by twisting or electrical stimulation, more surface area of the tissue is affected. Here is what happens on a cellular level:
- Number of fibroblasts (cells that produce proteins to lay down the building blocks of cells) increases = activating the repair process
- Signals in the cells (mechanotransduction) are created to mobilize free-stem cells (needed for repair of damaged tissue)
- This increases the body’s immune system response, sends out killer t-cells (cells that destroy infections), and inflammation is upregulated
- Your body senses the needle as “safe,” downregulates the immune system response, and begins releasing hormones of norepinephrine and epinephrine.
- Norepinephrine and epinephrine cause a stress response/inflammation in the body which leads to an increase in cortisol (regulates stress response and metabolism). Stay with me here, I know this sounds “bad,” but rest assured, cortisol is an essential hormone needed for this process.
- Cortisol binds to receptors that active a natural THC response (reduces pain sensation)
- This ultimately leads to an increase in nitric oxide which improves blood circulation and wound healing.
In summation, DN increases blood flood to the affected tissue by activating the natural healing process which helps repair the damaged tissue. DN is used local to the affected area different from acupuncture which is more systemic/whole body. I give this example: if you have headaches and I know they stem from tight neck muscles, I will needle those tight muscles; whereas an acupuncturist would needle points in the hands, feet, and face. DN is deep in the muscles and acupuncture is more superficial. The philosophy behind DN and acupuncture differs, but the technique is essentially the same.
The great news about DN is that it can help with a variety of impairments and issues. Typically, DN is used for trigger points, taunt, and pernicious bands in the muscles, to reduce muscle tension and associated pain. However, DN is so much more! Did you know that DN can help create synovial fluid in arthritic joints? A study published in 2022 concluded that three sessions of dry needling is more effective than three weeks of self-stretching to improve hip muscle extensibility in patients with hip osteoarthritis. Below is a short list of impairments DN can improve, repair, and reduce pain with:
- Muscle tightness
- Nerve pain
- Osteoarthritis
- Spinal conditions such as stenosis, spondylosis, facet arthrosis, etc
- Tendinopathy
- Knee injuries such as meniscus, ACL, etc
- Plantar fasciitis
- Complex regional pain syndrome
- Pre-operative joints
- Scar tissue reduction
- Scar tissue appearance
- And many more!
Frequently Asked Questions:
- Does dry needling hurt?
Most people do not feel the needle break the skin because of how thin it is. There can be muscle twitching once the needle reaches the depth of the muscle which may elicit pain. This pain sensation only lasts a couple of seconds before dissipating. It is also normal to feel a deep, dull ache. These sensations of twitching or a deep ache are normal and are typically known to mean we are affecting the right tissue.
- Are there any side effects?
You may experience muscle soreness following DN treatment. It almost feels like you worked out hard. Again, this is normal and goes away within a few days. Using heat, consuming more water, gentle stretching, and light activity will help with any residual soreness.
- How long does it take to see results?
Some people notice results immediately. For instance, there is a tremendous amount of success in improving joint range of motion immediately following dry needling. I have seen this especially at the shoulder. Others may not notice results until soreness subsides. Typically people notice improvements after 2-3 visits.
- What are the outcomes of DN?
Depending on the area treated, you will experience one or more of the following: reduced pain, improved mobility, improved range of motion, or reduced nerve pain/neural tension.
- How does dry needling fit into the physical therapy environment?
DN works extremely well in conjunction with physical therapy treatment. When being treated with DN, you want to ensure you are addressing the issue in other ways as well. DN is helpful for acute, subacute, and chronic injuries and pain. DN can help stop the pain cycle early on in treatment. It can also overcome plateaus in progress. In regards to chronic pain, DN is very helpful but it may take more time to see long-term results.
Are you someone who may benefit from DN? Ask your physical therapist or call today for more information!