Dry needling is a modality utilized to address soft tissue dysfunction and pain. Also known as myofascial trigger point therapy, Dry Needling is a physical therapist’s advanced technique for trigger point release. 

The goal of dry needling is to create a twitch response and depolarize the muscle membrane. During the dry needling treatment, needles are slowly inserted into the tight muscle, gently manipulated, and removed after a short period of time.  This is repeated in other muscles on different parts of the body if needed. This advanced, high-level technique causes a microscopic lesion in the soft tissue that stimulates the body to initiate a reparative response (self-healing).

 

While acupuncture is used to decrease pain by stimulating meridians of correlated organ systems, Dry Needling is used to target specific trigger points and stimulate nerve impulses with the same thin filiform needles (acupuncture needles). 

 

The science:

  • Fascia – a very thin form of connective tissue, it surrounds and infuses all the structures in the body. The Fascia very commonly undergoes changes and distortions that create a multitude of problems around muscles and joints.  Dry needling breaks up tight fascia. This rare form of manual therapy works quicker than any other method currently available. 
  • Dry Needling stimulates the body to produce a functioning microcirculatory system.  At the local level (within the muscle)  Adenosine and Nitric Oxide are released in response to dry needling.  Adenosine and Nitric Oxide are local vasodilators that improve circulation to the soft tissue.  This increase in blood flow carries more nutrient rich blood to the soft tissue to improve the potential of repair. 
  • Calcitonin gene related peptide (CGRP) is a local anti-inflammatory and anti-nociceptive (pain killer) that is also released by the body in response to dry needling.   The self-healing potential of the body is further facilitated by decreasing the inflammation in the soft tissue.
  • Dry needling also triggers a response in the central nervous system (the brain/spinal cord) that causes a cascade of events to promote self-healing.  Enkephalin is an anti-nociceptive (pain killer) that is released in the dorsal horn (a section of the spinal cord) in response to dry needling.  This alters the pain signal to the brain and can significantly reduce the pain signal being generated by soft tissue dysfunction.  
  • You don’t have to be in pain to feel better as a result of dry needling either since it releases Beta-Endorphins, which is an endogenous opioid neuropeptide found in the neurons of both the central and peripheral nervous system.  This is basically a “feel good” peptide released by your nervous system that can also be taken advantage of to promote a quicker recovery.

The American Physical Therapy Association’s Views on Dry Needling:  https://www.apta.org/PTinMotion/2015/5/DryNeedling/

 

Precautions:

As with all physical therapy techniques there are some associated precautions and contraindications for dry needling.  Common precautions include but are not limited to: the use of blood thinners, cancer in other areas, and diabetes.  Contraindications to dry needling include but are not limited to: blood born pathogens (Hepatitis B, Hepatitis C, HIV, AIDS), pregnancy, the area where active skin lesions are present, blood diseases (hemophilia, anemia), and cancer in the area(s) of metastasis.