Pull out a needle in the clinic and some people run for the hills. Other patients seem to seek it out after realizing what a powerful treatment tool they can be. I thought it would be beneficial to have all of the information here in one spot for you to form your own opinion and thoughts on the subject.
I’ll address this early. Short answer, no. Acupuncture is a practice born out of traditional Chinese medicine, in which thin needles are inserted into specific points on the body in an effort to balance the chi (or “Qi” - energy flow) of the body and therefore improving the body’s ability to heal itself. I am not an acupuncturist, nor do I claim to be one. Due to this, I can only educate on what I have been taught and what I have been told by professionals on what acupuncture is. The point is - dry needling is not the same. It is worth acknowledging that many professions argue over who shouldn’t and shouldn’t be able to utilize treatments for musculoskeletal conditions. This can lead to some hostility and differing beliefs between practitioners, and therefore you may have a different view on needling or acupuncture based on your specific experience.
Dry needling is the insertion of a monofilament needle into the body for therapeutic purposes. The term “dry” refers to the fact that nothing is injected into the body through the needles, such as during a vaccine or corticosteroid injection. Dry needling practitioners and acupuncturists typically utilize the same needles. Due to some of the hostility between communities that I mentioned earlier, new needles are now produced uniquely named as “dry needles” in an effort to more easily distinguish the two. The big difference with dry needling compared to acupuncture is the clinical intent, or what the goal is. Dry needling is a more “Western” or “modern” practice, for lack of better terms, in that the needle is used to target a specific anatomical structure. For example, a practitioner may choose to target tendon, ligament, muscle, fascia, perineural tissue, or scar.
Dry needling has shown benefit in numerous studies and numerous conditions. There is also literature citing that needling is relatively ineffective. A large reason for this is the differing methods behind how research on dry needling is being done. That said, it is so relatively new that we still don’t completely understand the mechanism behind how it works. There are many proposed theories. One of which is by “releasing” muscle and fascia in the painful area. Another theory, and more plausible in my humble opinion, is that needling of the area results in a neurophysiological healing cascade and allowing a “break” in the oftentimes stubborn pain cycle. You may be thinking at this point, is it even worth it? I would say the answer is the always popular “it depends”.
I believe dry needling can be a very powerful tool in the treatment of many conditions and I have seen it work on numerous occasions. However, I do not dry needle every patient that walks into my practice. There are so many different factors to consider when deciding whether or not to include dry needling within a plan of care, including personal factors, patient expectations/fears, body region, and alternative treatment options. I believe having a thorough assessment by a trusted medical professional is what makes or breaks the results of dry needling. The practitioner needs to be able to identify who is appropriate for dry needling treatment and who may not be. This is also why, in my opinion, that the research results are so mixed. Dry needling can work wonders for some people and do nothing for others based on the aforementioned factors. The random grouping that occurs in standardized research studies can skew the results by not taking these individualized factors into consideration. These studies are often designed by splitting up a group of individuals in a certain kind of pain, low back pain for example. One group will have dry needling added to their plan of care and the other will have some kind of sham or “placebo”. The other consideration is that it is difficult to create a believable sham or “placebo” when talking about needling because it is fairly easy to determine, as the patient, if you are having a needle inserted in your body. Some studies combat this by choosing to utilize a “needle stick” as a placebo where a needle is inserted into the skin, but not advanced or manipulated to the target tissue as a typical treatment would entail. Some will argue, however, that just the act of breaking the skin can trigger some of the healing cascade benefits and thus skew the results.
A taut band of muscle, sometimes referred to as a knot or a trigger point, is a common target for needling practitioners. The placement of a needle in one of these points can lead to what is called a “twitch response” or an involuntary twitch in the muscle. Many believe this response to be important component in the treatment of these points. There are, however, many uses with a needle under the umbrella of “dry needling”. It may be utilized to increase range of motion in tissue, including muscle tissue and scar tissue. It may be used to activate a muscle in conjunction with an electrical stimulation unit, such as is shown in the video shown here. A needle may also be used to stimulate nerve tissue.
This is always one of the first questions I get from interested patients, and rightfully so. Dry needling is an invasive procedure (albeit minimally) and it is important to consider the risks with your qualified needling provider. The important thing to consider is that DRY NEEDLING IS SAFE. There are multiple studies citing how little the risk of a serious complication during a dry needling treatment is, provided that the technique utilized is safe and the practitioner is knowledgable on the associated anatomy. The most common minor complications include bleeding (typically minor, such as after an injection), pain/soreness during or after treatment, and bruising. The major complications associated with dry needling are pneumothorax (collapsed lung), puncture of vital tissue or organ, or systemic infection. These are all significantly mitigated by proper training and regulation as to who is allowed to perform dry needling.
The most common feeling and description that I hear from patients undergoing needling is a “deep ache” while the needle is being inserted into a specific muscle. Patients may or may not feel the initial insertion of the needle. However, the feeling and experience from dry needling can vary from person to person, body region to body region, and from day to day. Unfortunately it looks as though I will have to leave you with another answer of “it depends” based on the individual factors.
Dr. Ryan Queen is a doctor of physical therapy, certified strength and conditioning specialist, and level 1 certified precision nutrition coach, in addition to holding certifications in other adjunct treatment modalities and paradigms.
He created Revolution Performance as a gym-based physical therapy practice and wellness coaching service after becoming frustrated by the conflict of interest that health insurance company restrictions bring. His vision with the company has always been to provide high quality, holistic care while forming life-long relationships.
His mission is to help busy, hard-working adults get out of pain and dysfunction, whether from a current injury, a past one, or just daily aches and pains. In addition, Ryan has a passion for creating a proactive environment where issues are addressed before they become debilitating, or even before they exist.
After working 40 hours a week at a full time job while going to physical therapy school, Ryan knows how it feels to think you do not have enough time in the day to take care of yourself in all facets of health. It has been a goal of his to share the information and strategies he has learned to help others improve their overall health and become more productive.
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