Functional Dry Needling

Functional Dry Needling


What is dry needling?

Dry needling is an invasive procedure in which a solid filament needle is inserted into the skin and muscle directly at a myofascial trigger point. A myofascial trigger point consists of multiple contraction knots, which are related to the production and maintenance of the pain cycle.

Is dry needling similar to acupuncture?

There are many similarities and differences between dry needling and acupuncture. Licensed physical therapists in a growing number of states can use dry needling under the scope of their practice. Dry needling also falls within the scope of acupuncture practice. Physical therapists at PT Now are not licensed acupuncturists and do not practice acupuncture. In contrast to most schools of acupuncture, dry needling is strictly based on Western medicine principles and research.

How does dry needling work?

The exact mechanisms of dry needling are not known. There are mechanical and biochemical effects. Based on the pioneering studies of Dr. Jay Shah and colleagues at the National Institute of Health, we know that inserting a needle into trigger points can cause favorable biochemical changes, which assist in reducing pain. It is essential to elicit so-called local twitch responses, which are spinal cord reflexes. Getting local twitch responses with dry needling is the first step in breaking the pain cycle.

What types of problems can be treated with dry needling?

Dry needling can be used to treat a variety of musculoskeletal problems. Muscles are thought to be a primary contributing factor to the symptoms. Such conditions include, but are not limited to neck, back, shoulder, arm pain (tennis elbow, carpal tunnel, golfer’s elbow), migraine and tension-type headaches, jaw pain, buttock pain, and leg pain (sciatica, hamstring strains, calf tightness/spasms). The treatment of the muscles has a profound effect on reducing the pain mechanisms in the nervous system.

Is the procedure painful?

Most patients do not feel the insertion of the needle. The local twitch response elicits a very brief (less than a second) painful response. Some patients describe this as a little electric shock; others feel it is more like a deep cramping sensation. Again, the therapeutic response occurs with the elicitation of local twitch responses and that is a good and desirable reaction.

Are the needles sterile?

Yes, we only use sterile disposable needles.

Can I perform dry needling as part of my home program?

No, dry needling requires extensive training and should never be tried at home.

What side effects can I expect after the treatment?

Most patients report being sore after the procedure is completed. The soreness is described as muscle soreness over the area treated and into the area of referred symptoms. Typically, the soreness lasts from a few hours to two days. 

What should I do after receiving dry needling as a treatment?

Our recommendations vary depending on the amount of soreness you have and on the individual’s response to the treatment. Recommendations may include heat or cold application to the area, gentle stretching, and modification of activities.

How long does it take for the procedure to work?

Typically, it takes several visits for a positive reaction to take place. Again, we are trying to cause mechanical and biochemical changes without any pharmacologic means. Therefore, we are looking for a cumulative response to achieve a certain threshold after which the pain cycle is disturbed.

Why is my doctor not familiar with dry needling?

In the US, dry needling is a relatively new method for treating myofascial pain and not everyone is aware of this effective modality. Feel free to inform your doctor about this treatment option. It is upon of all of us to educate others about new and innovative ways to treat pain.

Where does dry needling fit into the entire rehabilitation program?

Generally speaking, dry needling is the modality of choice when it comes to treating patients in the clinic. More frequently, dry needling is needed in the beginning in order to break the pain cycle. Once that is achieved, other treatment options are introduced.

Once I am feeling better, how often do I need to come back to maintain my progress?

The musculoskeletal system is under constant pressure from gravity, stress, work, etc. A regular exercise program combined with good posture can prevent many problems. If the pain comes back, “tune-ups” are recommended to treat and prevent serious injury.