The ins and outs of Dry Needling
February 21, 2018 at 3:06 PM
What is Dry Needling?
Dry needing is a technique that involves multiple advances of a fine filament needle into a muscle to treat muscle pain and dysfunction. While the technique is similar to acupuncture, in that it uses the same dry needle (needle without medication), the methodology for dry needling is different.
Acupuncture is based on Eastern Medicine Principles and involves the insertion of needles into the skin at specific points along meridians, to restore energy or ‘Qi”, and unblock channels. Dry needling is based on Western Medicine Principles and involves the insertion of the same needle into a myofascial trigger point within a specific dermatomal or myotomal distribution.
A trigger point is a hyperirritable spot within a taut band of dysfunctional muscle. These result from increased spontaneous electrical activity of the injured or overloaded muscle, causing focal muscle fibre contraction/muscle cramps and increasing the sensitivity of the pain receptors in the muscle. These spots are painful on compression and can give rise to characteristic referred pain, tenderness and autonomic phenomena. Trigger points develop as a result of injury, overuse, muscle imbalance, postural abnormalities or nerve impingement.
What is the aim of Dry Needling?
The aim of dry needling is to elicit a ‘local twitch response’ to relieve the pain and tension in the muscle. Patients feel little to no discomfort when a fine filament needle is inserted into healthy muscle, however if a muscle is sensitive or shortened, patients feel a sensation like a muscle cramp - this is the local twitch response or ‘Jump Sign’. Patient’s may also feel a reproduction of ‘their’ pain, which is a helpful diagnostic indicator for the practitioner attempting to diagnose the cause of the patient’s symptoms.
The local twitch response is an involuntary spinal reflex contraction of muscle fibres that occurs during needling a taut band of muscle. Eliciting a twitch response decreases the spontaneous electrical activity of the muscle, and reduces or eliminates painful, irritating chemicals in trigger points. The local twitch response is also associated with the muscle relaxing, which will allow the muscle to function as they were designed to, thereby reducing stress on adjacent areas including tendons, ligaments, bursa and nerves. Therefore, dry needling directly treats the neuromuscular system and immediately improves symptoms of pain and irritation, muscle tightness, joint mobility and function.
Are there any complications to Dry Needling?
Dry needling is a safe and effective treatment technique, with very few side effects. The most common side effect patients experience is temporary muscle soreness for 1-2 days, and in some patients fatigue for half a day after the treatment. Your clinician will instruct you how to minimise these complications. Less common side effects may include some bruising, and in more sensitive patients a vasovagal reaction.
More serious post needling complications firstly, may include a pneumothorax (collapsed lung). This may occur if the fine filament needle penetrates the lung field. Needling over the rib cage is an advanced technique that should only be used by an experienced practitioner with the appropriate training. If you have received needling over the chest and are experiencing chest pain that radiates through the chest wall, the feeling of a bubble or shortness of breath, you MUST confirm your symptoms with a chest X-ray.
Because dry needling is an invasive technique, there is a risk of infection, even if remote. You will notice your therapist prepare the treatment area with alcohol, wearing gloves and using sterile needles with every treatment. We can proudly say that we have never caused a pneumothorax or an infection in our needling therapies at Auckland Physiotherapy.
Who should not receive Dry Needling?
Not everyone is a suitable candidate for dry needling and you should never feel like you are being forced into it if you are unwilling or lacking confidence in a practitioner proposing the treatment. Below are some further contraindications to dry needling to consider.
- Needle phobia
- Metal allergies
- Local Infection
- Bleeding disorders (e.g. haemophilia) or if a patient is on anticoagulants
- Pregnancy (especially in the first trimester)
- In the area over a joint replacement (for up to 6 months), breast implant or cardiac pacemaker
- Following axillary (or inguinal) node dissection
- NB – Blood donors should inform the blood bank prior to donating as restrictions may apply.
Who can benefit from dry needling?
Trigger points are frequently associated with tendinitis, bursitis, and neuropathic pain resulting from spinal degeneration, among other things. Providing none of the above contraindications apply to you, dry needling can be used to treat almost anyone experiencing a variety of pain problems including, but not limited to:
- Acute and chronic sporting injuries
- Repetitive strain injuries and overuse syndromes
- Headaches and whiplash
- Neck and back pain
- Muscle strains and spasms
- Joint pain including arthritis
- Spinal conditions where the underlying pathology may have triggered a movement disorder i.e. Piriformis syndrome, cervico-genic headaches, sciatica, hamstring issues
Remember dry needling is an invasive technique and can only be performed by a licensed healthcare practitioner, with a minimum of two years experience, who has passed the appropriate certification standards. In combination with other forms of treatment or as a standalone, dry needling is an extremely effective way to treat neuromuscular dysfunction, and greatly reduce pain and discomfort with little to no side effects.
I hope that this brief overview has provided you a better understanding about dry needling, and how it is used at Auckland Physiotherapy. If you would like more information on our dry needling services, please call or email our clinic, or book in with Natalie to see if this is a suitable treatment for you.