Dry Needling

Overview

What is Dry Needling for?

Risks

How you prepare

What happens during Dry Needling Treatments?

After Dry Needling

Success with Dry Needling

  • Overview

Dry Needling is a technique that uses a very thin needle that is pushed through the skin to stimulate a trigger point
[1]

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Journal of Orthopaedic & Sports Physical Therapy

Peer-reviewed journal

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with the goal of releasing/inactivating the trigger point and relieve pain.
[2]

Virginia Board of Physical Therapy

Governing State Board

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Trigger points are distinct spots in taut bands
[3]

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Academic textbook

Backed by various research articles

Written for professionals

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of skeletal muscle that are easily irritated. Pain from a trigger point can be local or can refer in a pattern.
[4]

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International Scholarly Research Notices

Peer-reviewed journal

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Many people wonder what the difference is between acupuncture and dry needling.    The difference is in the history and it’s intended effects:

Traditional Chinese medicine birthed traditional acupuncture.    Traditional acupuncture treats an energy in your body called Qi, focuses on restoring the flow of Qi, and includes concepts of yin/yang.
[5]

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British Journal of Sports Medicine

Peer-reviewed journal

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Leading journal in the field

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[6]

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Journal of the British Medical Acupuncture Society

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Internationally recognized journal

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Dry needling originated from Western medical acupuncture which relies heavily on evidence-based science like anatomy, physiology, and pathology.
[7]

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Acupuncture in Medicine

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Internationally recognized journal

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Dry needling is used to treat musculoskeletal pain, including myofascial trigger point pain.
[6]

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Journal of the British Medical Acupuncture Society

Peer-reviewed journal

Internationally recognized journal

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Top view of a dry needling treatment in a physiotherapy clinic.

  • What is Dry Needling for?

While trigger points don’t have a single factor for their pesky origin, they usually arise from muscle overuse (i.e., poor posture or repetitive motion), trauma (i.e., an acute injury to the muscle), or psychological stressors (i.e., lack of sleep, depression, anxiety).
[8]

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Dry needling takes advantage of mechanical pressure which essentially causes the collagen fibers to become polarized.    When the collagen fibers become polarized, they cannot hold structure;
[9]

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MSOE Center for BioMolecular Modeling

Educational College

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so, tissue remodeling is triggered.
[10]

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American Journal of Physical Medicine & Rehabilitation

Peer-reviewed journal

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In short, the goals of dry needling are to reduce pain, inactivate trigger points and restore function.

Benefits of dry needling:

  • Controlling pain
    [11]

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    Current Pain and Headache Reports

    Peer-reviewed journal

    Written by experts

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  • Reducing muscle tension
    [11]

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    Current Pain and Headache Reports

    Peer-reviewed journal

    Written by experts

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    [12]

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    Journal of Manual & Manipulative Therapy

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  • Increased range of motion

  • Remodeling tissue
    [13]

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    Evidence-based complementary and alternative medicine

    Peer-reviewed journal

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    to function better
  • Relaxing the patient
    [11]

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    Current Pain and Headache Reports

    Peer-reviewed journal

    Written by experts

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Patients often seek dry needling treatments for:

  • Tension headaches
    [14]

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    Medicine

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  • Low back pain
    [15]

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    Medicine

    Peer-reviewed journal

    Highly respected journal

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  • Tennis elbow
    [16]

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    The Physician and Sports medicine

    Peer-reviewed journal

    Highly respected journal

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  • Golfer's elbow
    [16]

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    The Physician and Sports medicine

    Peer-reviewed journal

    Highly respected journal

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  • Jumper’s knee
    [16]

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    The Physician and Sports medicine

    Peer-reviewed journal

    Highly respected journal

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  • Achilles’ tendonitis
    [16]

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    The Physician and Sports medicine

    Peer-reviewed journal

    Highly respected journal

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  • Biceps tendonitis
    [16]

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    The Physician and Sports medicine

    Peer-reviewed journal

    Highly respected journal

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  • Triceps tendonitis
    [16]

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    The Physician and Sports medicine

    Peer-reviewed journal

    Highly respected journal

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  • IT band syndrome
    [16]

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    The Physician and Sports medicine

    Peer-reviewed journal

    Highly respected journal

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  • Shoulder pain

Call for an Appointment

480-585-5577

or Request an Appointment Online

Call for an Appointment

480-585-5577

or Request an Appointment Online

  • Risks

Since dry needling carries a low risk,
[17]

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many patients do not experience any side effects following a dry needling session. Side effects with dry needling are most often mild.

Dry needling side effects include:

  • Increase in pain. There is some discomfort with dry needling but it is short-lived.    Since the needles being used are very small gauge, there is minimal pain with needle insertion.    The twitch response may feel like a cramp in the muscle and lasts up to 30 seconds.    Soreness post dry needling can last 24 to 48 hours and will usually self-resolve.

  • Bleeding or Bruising. occurs at the needle insertion point and affects approximately 10% of patients. Patients taking blood thinners or with blood vessel problems tend to experience it more.

  • Fainting. is likely due to being dehydrated, patients that haven’t eaten before their appointment, or low blood pressure.

  • Fatigue or Tiredness. is part of the healing process and usually is an indication treatment is working.

  • Skin Reactions. are due to an allergic reaction to the metal the needle is made with.    It can be identified by small red spots on the skin.

Adverse reactions to dry needling are rare, but include:

  • Pneumothorax. or a collapsed lung is caused by improper needle insertion over the lung field

  • Nerve injury. Neurapraxia is when the myelin sheath is damaged. Typically, will resolve within a few weeks or months.
    [18]

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    Muscle & nerve

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  • Axonotmesis is when the nerve itself has been damaged, prognosis is dependent upon the area and ranges from good to poor.
    [18]

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    Muscle & nerve

    Peer-reviewed journal

    Internationally recognized journal

    Multi-disciplinary journal

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Dry Needling isn’t for everyone. Your doctor might caution against dry needling if:

  • You are Pregnant
    [19]

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    Academic textbook

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  • Using a medication for anticoagulant therapy
    [20]

    Trusted Source

    Journal of Orthopaedic & Sports Physical Therapy

    Peer-reviewed journal

    Internationally recognized journal

    Leading journal in the field

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  • Have thrombocytopenia
    [21]

    Trusted Source

    Cochrane Database of Systematic Reviews

    Peer-reviewed journal

    Leading journal in the field

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  • You do not understand the treatment
    [19]

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    Academic textbook

    Backed by various research articles

    Written for professionals

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  • If you have a needle phobia
    [19]

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    Written for professionals

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  • diabetes

  • HIV, Hepatitis B or Hepatitis C

  • recurrent infections

  • history of seizures that were induced with medical procedures

  • How you prepare

No special preparations are usually needed for dry needling therapy.

Food and medications

  • You don’t need to restrict your diet or avoid particular activities in preparation for dry needling, but it is important to eat before.

Clothing and personal items

  • Wear loose, comfortable clothing.

  • What happens during Dry Needling Treatments?

Trigger points are located through examination and by feeling the muscles to locate the area of pain.

Depending on the area being treated, patients are either sitting or lying down. Needles are inserted to various depths depending on where the trigger point is located.

Filiform needles are used during dry needling.    Filiform needles are so thin, patient’s often do not feel them being inserted.

There may be mild discomfort when the needle activates the twitch response that feels like a mild ache.

Needles may be manipulated in a variety of ways including but not limited to: a gentle in and out technique, a twisting technique or the needles may be attached to a TENS unit.

Typically, needles are left in place for up to 20 minutes before they are painlessly removed.

  • After Dry Needling

After dry needling, mild soreness in the area treated is normal.    There can be immediate soreness, or it can develop the next day. Patients may also feel tired, or sleepy, this is also a normal response and typically lasts a few hours. To ease pain and soreness after dry needling, patients should Increase water intake and apply ice to the area as needed.    Patients should be able to return to normal activities immediately after dry needling.

Contact the office or your doctor if you:

  • Have shortness of breath or a dry persistent cough following dry needling.

  • Success with Dry Needling

Research suggests dry needling works better than sham (fake) needling
[20]

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Journal of Orthopaedic & Sports Physical Therapy

Peer-reviewed journal

Internationally recognized journal

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as well as effectiveness being confirmed many studies including 2 systematic reviews.
[17]

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The Journal of the American Board of Family Medicine

Peer-reviewed journal

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A 2005 review of randomized controlled trials concluded that dry needling may provide relief for low back pain.
[21]

Trusted Source

Cochrane Database of Systematic Reviews

Peer-reviewed journal

Leading journal in the field

Go to source


Many patients have improved mobility and decreased pain immediately; however, typically, it takes 2-3 dry needling sessions before results are seen.

In order to back up the information in our articles, Arizona Chiropractic & Holistic Health Center exclusively cites high-quality sources such as peer-reviewed research. We strive to provide accurate, dependable, and trustworthy content based on the best evidence avaliable.

  1. Painful and Tender Muscles: Dry Needling Can Reduce Myofascial Pain Related to Trigger Points Muscles. (2013b). Journal of Orthopaedic & Sports Physical Therapy, 43(9), 635. https://doi.org/10.2519/jospt.2013.0505
  2. Virginia Board of Physical Therapy Task Force on Dry Needling. (2007, March 30). Meeting minutes. Department of Health Professions, Richmond, Virginia. https://townhall.virginia.gov/L/GetFile.cfm?File=Meeting%5C133%5C9077%5Cminutes_dhp_9077_v3.pdf
  3. Ocs, D. P. J. D. M., Fernández-De-Las-Peñas, C., Finnegan, M., & Freeman, J. L. (2018). Travell, Simons & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual (3rd ed.). LWW. ISBN-13 978-0781755603
  4. Jafri, M. S. (2014). Mechanisms of Myofascial Pain. International Scholarly Research Notices, 2014, 1–16. https://doi.org/10.1155/2014/523924
  5. Meakins, A. (2016). Acupuncture: what’s the point? British Journal of Sports Medicine, 51(6), 484. https://doi.org/10.1136/bjsports-2016-096248
  6. White, A., & Editorial Board of Acupuncture in Medicine (2009). Western medical acupuncture: a definition. Acupuncture in medicine : journal of the British Medical Acupuncture Society, 27(1), 33–35. https://doi.org/10.1136/aim.2008.000372
  7. Zhou, K., Ma, Y., & Brogan, M. S. (2015). Dry Needling versus Acupuncture: The Ongoing Debate. Acupuncture in Medicine, 33(6), 485–490. https://doi.org/10.1136/acupmed-2015-010911
  8. Md, W. F. R., PhD, Md, J. S. K., & Jr., T. R. D., MD. (2018). Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation (4th ed.). Elsevier. ISBN-13: 978-0323549479
  9. Alverno College, MSOE Center for BioMolecular Modeling, 2015. (n.d.). Collagen. MSOE Center for BioMolecular Modeling. Retrieved August 31, 2021, from https://cbm.msoe.edu/crest/ePosters/a15collagen.html
  10. Chen, J. T., Chung, K. C., Hou, C. R., Kuan, T. S., Chen, S. M., & Hong, C. Z. (2001). Inhibitory Effect of Dry Needling on the Spontaneous Electrical Activity Recorded from Myofascial Trigger Spots of Rabbit Skeletal Muscle. American Journal of Physical Medicine & Rehabilitation, 80(10), 729–735. https://doi.org/10.1097/00002060-200110000-00004
  11. Cagnie, B., Dewitte, V., Barbe, T., Timmermans, F., Delrue, N., & Meeus, M. (2013). Physiologic Effects of Dry Needling. Current Pain and Headache Reports, 17(8). https://doi.org/10.1007/s11916-013-0348-5
  12. Dommerholt J. (2011). Dry needling - peripheral and central considerations. The Journal of manual & manipulative therapy, 19(4), 223–227. https://doi.org/10.1179/106698111X13129729552065
  13. Bai, Y., Wang, J., Wu, J. P., Dai, J. X., Sha, O., Tai Wai Yew, D., Yuan, L., & Liang, Q. N. (2011). Review of evidence suggesting that the fascia network could be the anatomical basis for acupoints and meridians in the human body. Evidence-based complementary and alternative medicine : eCAM, 2011, 260510. https://doi.org/10.1155/2011/260510
  14. Gildir, S., Tüzün, E. H., Eroğlu, G., & Eker, L. (2019). A randomized trial of trigger point dry needling versus sham needling for chronic tension-type headache. Medicine, 98(8), e14520. https://doi.org/10.1097/md.0000000000014520
  15. Hu, H. T., Gao, H., Ma, R. J., Zhao, X. F., Tian, H. F., & Li, L. (2018). Is dry needling effective for low back pain? Medicine, 97(26), e11225. https://doi.org/10.1097/md.0000000000011225
  16. Krey, D., Borchers, J., & McCamey, K. (2015). Tendon needling for treatment of tendinopathy: A systematic review. The Physician and Sports medicine, 43(1), 80–86. https://doi.org/10.1080/00913847.2015.1004296
  17. Kalichman, L., & Vulfsons, S. (2010). Dry Needling in the Management of Musculoskeletal Pain. The Journal of the American Board of Family Medicine, 23(5), 640–646. https://doi.org/10.3122/jabfm.2010.05.090296
  18. Robinson L. R. (2000). Traumatic injury to peripheral nerves. Muscle & nerve, 23(6), 863–873. https://doi.org/10.1002/(sici)1097-4598(200006)23:6<863::aid-mus4>3.0.co;2-0
  19. Dommerholt J., Fernandez-de-las-Penas C. Trigger Point Dry Needling. An Evidenced and Clinical-Based Approach (2nd ed.). Edinburgh: Churchill Livingstone-Elsevier, 2013 ISBN-13: 978-0702074165
  20. Kietrys, D. M., 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), 620–634. https://doi.org/10.2519/jospt.2013.4668
  21. Furlan, A. D., van Tulder, M. W., Cherkin, D., Tsukayama, H., Lao, L., Koes, B. W., & Berman, B. M. (2005). Acupuncture and dry-needling for low back pain. Cochrane Database of Systematic Reviews. Published. https://doi.org/10.1002/14651858.cd001351.pub2