Anything with needles can understandably freak people out, but more and more physical therapists are offering a new kind of treatment called dry needling. We asked physical therapist Erin Adams, DPT, CMTPT (certified myofascial trigger point therapist), from Fit2Perform [1], who's been performing dry needling for four years, to explain all about it so you can determine if it's something you need.
What Is Dry Needling?
Dry needling is a treatment provided by a trained professional that uses a thin filiform needle (acupuncture needle) to penetrate the skin and stimulate underlying myofascial trigger points, muscles, and connective tissues, Erin explained. The purpose of dry needling is to help manage pain and improve movement impairments such as muscle tightness.
The practitioner inserts the thin needle into a trigger point, which is a hard or knotted muscle, helping to release the knot and relieve any muscle pain or spasms. The needle stays in the skin for a short time; the practitioner determines how long. They may insert and remove the needle or they may poke it around a little before removing it to further stimulate the muscle.
What Can a Person Expect From a Dry Needling Treatment?
Erin explained that everyone has a slightly different experience from dry needling. How much you feel the dry needling happening depends on your practitioner's skill level, your ability to relax during treatment, hydration, and the level of injury being treated.
"Following needle insertion, there is an expected local twitch response from the target muscle being treated," Erin said. "This is considered a good sign and connected to the positive results of dry needling in research [2]." You may feel a deep ache or burning and soreness as the needle is manipulated underneath the surface of the skin.
Is Dry Needling Safe?
"As dry needling grows in popularity as a form of treatment for pain and movement dysfunction, there are more and more certifications available for different types of practitioners," Erin said. Different certifications will provide various levels of intensive or nonintensive studies and practice, just like with any educational program.
You should be aware that not all programs require you to pass an examination following completion of the program, so you definitely want to inquire about the level of training your practitioner has to make sure you're getting a safe and effective application, Erin warned. She said to ask questions such as: "How many hours did you spend training?" "Which program did you study under?" "Did you have to pass a certification examination?" and "How many years have you been doing dry needling?" This will give you a fair idea of the depth of practice your professional has.
Although some of this information may seem intimidating, the benefits of dry needling far outweigh the possible side effects, Erin said. "I find that I get more sore from working out or hiking than I would from dry needling," she noted.
What Are the Risks of Dry Needling?
"Although these side effects are rare, there is risk for side effects to occur," Erin said. Your practitioner should explain the risk factors to you, which include bruising, muscle soreness, dizziness, fainting, drowsiness, fatigue, and infection.
Your practitioner may choose to alter treatment methods or not treat you at all if you have certain conditions, such as abnormal bleeding tendencies, a compromised immune system, vascular disease, pregnancy, or allergies to metals or implanted devices. "It's imperative that your practitioner ask you about these conditions and that you disclose that information," Erin said.
Who Would Benefit From Dry Needling?
Anyone can benefit from dry needling, Erin said. "Certain ailments that are most commonly treated with dry needling include muscular tension/stiffness, muscular or joint pain, muscular injury (strain, sprain, or tear), restricted joint range of motion, muscle cramps, pelvic pain, migraines and tension-type headaches, jaw problems, as well as spinal and disc problems." In the photo above, the patient is receiving dry needling for scar tissue after a surgical repair of a fracture.
What Can a Person Expect After a Dry Needling Treatment?
It's very common for the area treated to feel sore, tender, and tight for one to three days. "This muscle soreness feels much like that of a bruise or DOMS (delayed onset of muscle soreness) that you get after working out," Erin explained. Stretching, movement, and heat can alleviate this.
Expectations following dry needling depend on the purpose of the treatment. "If you're working on muscle flexibility, you should expect improved range of motion. If you're working on pain, you should expect decreased pain," Erin said. Since the area can feel sore for up to three days, Erin said that you may not notice results until after this initial period of soreness resolves. "I always recommend movement after dry needling but not maximum output performance. Movement such as walking and gentle stretching will improve results," Erin said.
How Often Should a Person Get Dry Needling?
Dry needling doesn't have a restriction as far as frequency. However, Erin recommended full recovery from side effects such as soreness before having a follow-up dry needling session. "It's beneficial to understand the effects of dry needling on yourself prior to a second session, to know how much intensity should be used on the next session," Erin said.
Note that one session costs around $75, and insurance may or may not pay for it. So that could determine how often you're able to go.
What's the Difference Between Dry Needling and Acupuncture?
Although the same types of needles are used for both, Erin explained, "Dry needling doesn't follow a map of predetermined points. Dry needling is directed to the specific soft tissue structure being treated and does not aim to affect energy or organ systems as acupuncture does." She added that dry needling tends to have a much deeper application than acupuncture.
What Does a Practitioner Want You to Know About Dry Needling?
"As a practitioner who has been performing dry needling for four years now, dry needling has shown to reduce pain and improve range of motion quicker than anything you can do on your own. I have found it more effective than massage and lasts longer," Erin said. She uses dry needling on more than half of her current clients, and, beyond clients' initial treatments, all dry needling sessions are upon request. Erin said to consider dry needling if you want to jump-start your recovery.