Dry Needling. What is it and what does it do?

What Is Dry Needling?

Dry needling is an invasive technique, using a very fine needle inserted into the skin to release myofascial trigger points. Trigger points are a hypersensitive region within a muscle that can cause pain and can present as a tight band within the muscle or a nodule, commonly referred to as ‘knots’. These trigger points can cause pain at the area and often refer pain around the region of the trigger point too. Dry needling helps in the release of the trigger point and the pain or discomfort that can be felt because of it.

What to expect from a Dry Needling treatment

When having dry needling treatment, a very thin needle is used that is pre-sterilised and protected, and only used once. The needle is placed over the muscle and is quickly tapped into the muscle. When inserted, a small scratch may be felt but it should not be too painful. The muscle being treated will sometimes contract when a needle inserted, this is called a local twitch response and may be a little uncomfortable but is completely normal. After insertion a deep ache may be felt. The insertion of the needle will produce an inflammatory response, so redness, heat and swelling may occur. Once the needle is in the muscle, the therapist may move the needle up and down, side to side or twisting the needle round, which helps to stretch the muscle fibres being treated. Needles can be left in for anywhere between 5 to 20 minutes.

How does Dry Needling help?

During the dry needling process, chemicals released from the body cause healing effects and help with the reversal of ischaemia by relaxing the muscle and increasing the blood flow to the area and oxygen saturation of the muscle (Kubo et al.,2010). These chemicals can also inhibit pain signals from the body to the brain helping to reduce pain and increase relaxation. As the needle is twisted or moved when inserted, it stretches the fascial tissue. This all helps with the recovery of the muscle affected by the trigger point. Dry needling is a way to help release myofascial tension, ease pain (Morihisa et al., 2016, Kietrys et al., 2013), and support tissue healing.

What conditions can Dry Needling help?

By using dry needling in conjunction with other treatments, it can help with different conditions in which myofascial tension occurs, such as:

• neck and shoulder pain (Calvo-Lobo et al., 2016),
• tension headaches (Gildir et al., 2019),  
• plantar heel pain (Cotchett et al., 2014),
• piriformis syndrome (Fusco et al., 2018)
• tennis elbow (Shariat et al., 2018).
  

References
Calvo-Lobo C, Pacheco-da-Costa S, Martínez-Martínez J, Rodríguez-Sanz D, Cuesta-Álvaro P, López-López D. Dry Needling on the Infraspinatus Latent and Active Myofascial Trigger Points in Older Adults With Nonspecific Shoulder Pain: A Randomized Clinical Trial. J Geriatr Phys Ther. 2016;41(1):1–13. doi:10.1519/JPT.0000000000000079
Cotchett, M., Munteanu, S., Landorf, K., Effectiveness of Trigger Point Dry Needling for Plantar Heel Pain: A Randomized Controlled Trial, Physical Therapy, Volume 94, Issue 8, 1 August 2014, Pages 1083–1094, https://doi.org/10.2522/ptj.20130255
Fusco P, Di Carlo S, Scimia P, Degan G, Petrucci E, Marinangeli F. Ultrasound-guided Dry Needling Treatment of Myofascial Trigger Points for Piriformis Syndrome Management: A Case Series. J Chiropr Med. 2018;17(3):198–200. doi:10.1016/j.jcm.2018.04.002
Gildir S, Tüzün EH, Eroğlu G, Eker L. A randomized trial of trigger point dry needling versus sham needling for chronic tension-type headache. Medicine (Baltimore). 2019;98(8):e14520. doi:10.1097/MD.0000000000014520
Kietrys, D., Palombaro, K.M., Azzaretto, E., Hubler, R., Schaller, B., Schlussel, J.M., Tucker, M. (2013) 'Effectiveness of Dry Needling for Upper-Quarter Myofascial Pain: A Systematic Review and Meta-analysis ',Journal of Orthopaedic & Sports Physical Therapy, 43(9), pp. 620-634.
Kubo, K., Yajima, H., Takayama, M. et al. Eur J Appl Physiol (2010) 109: 545. https://doi.org/10.1007/s00421-010-1368-z
Morihisa R, Eskew J, McNamara A, Young J. DRY NEEDLING IN SUBJECTS WITH MUSCULAR TRIGGER POINTS IN THE LOWER QUARTER: A SYSTEMATIC REVIEW. Int J Sports Phys Ther. 2016;11(1):1–14.
Shariat, A., Noormohammadpour, P., Hossein Memari, A., Ansari, N., Cleland, J and Kordi, R. Acute effects of one session dry needling on a chronic golfer’s elbow disability. J Exerc Rehab, 2018, 14, 138-142