Dry needling in physical therapy

A modern, non-aggressive approach to pain relief

Physical therapy is a versatile field that encompasses a wide range of techniques and treatments aimed at alleviating pain, improving mobility and enhancing overall function.

One such technique that has gained significant attention in recent years is dry needling.

Despite its growing popularity, many people are still unfamiliar with dry needling treatment, the benefits and how it works.

What is dry needling?

Let’s break it down.

Dry needling is a treatment that uses a dry needle – a needle without medicine – to treat areas of dysfunction and pain after an injury or overuse.

Different from acupuncture, it is rooted in modern Western medical principles and targets muscles and connective tissues to decrease pain and improve function. Dry needles can be used on trigger points: spots on your body that cause pain when you apply pressure to that area.

These trigger points are hyperirritable spots in the muscles that can cause chronic pain and discomfort, which can limit your daily functionality.

One way to distinguish the two is that acupuncture targets points along meridian lines to restore balance and proper energy flow in the body, while dry needling penetrates the skin at specific areas to release tension and initiate a healing response.

Dry needling also uses far fewer needles and is specifically used to restore function.

So, how does it work?

During your initial evaluation, a physical therapist will identify an underperforming muscle or an area of consistent discomfort. If dry needling is part of the treatment plan, they will insert a thin needle through the skin, into the muscle and then use the needle to reset the muscle.

Dry needling is only recommended and used if the patient feels comfortable doing so. Patient consent is required.

The length of the needle will depend on the area of your body that is being treated.

Some of the primary after-effects include:

Release of muscle tension – The insertion of the needle can help to release muscle tightness and knots, leading to reduced pain and improved overall function.
Increased blood flow – The needling process promotes increased blood flow to the affected area, which aids in the healing process.
Neurological effects – Dry needling can stimulate the nervous system, leading to changes in the way the body perceives pain. This may result in a reduction of pain signals being sent to the brain.
Chemical changes – The procedure may cause changes in the levels of certain chemicals in the body, such as the release of endorphins, which are natural pain relievers.

After the procedure, people can experience bruising at the dry needling site, fatigue or lack of energy and soreness. Of course, your physical therapist will constantly monitor your response during treatment.

A patient lying face down on a medical exam table with a physical therapist above them inserting a dry needle into the patient's shoulder.

Dry needling as a treatment

Dry needling is an increasingly popular technique used to treat a variety of musculoskeletal injuries and conditions. Some of these common injuries include lateral elbow pain from golfing, neck and back pain from everyday use, pinched nerves, etc.

Dry needling is also used alongside other therapies to treat:

Carpel tunnel syndrome, from sewing, typing, etc.
Face and jaw pain
Fibromyalgia, muscle pain that includes fatigue, sleep, memory and mood issues
Foot and ankle pain, including plantar fasciitis
Headache
Hip and leg pain, including muscle strain, calf-tightness or sciatica
Joint impingement pain
Low back pain
Neck pain, including radiculopathy (pinched nerve)
Shoulder and arm pain
Tendonitis, including tennis elbow, jumper’s knee and Achilles pain

Have you ever heard of the saying, “Where there’s smoke, there’s fire?”

If so, think of dry needling using this analogy.

You may have a muscle or area of your body that is tight, inflamed and causing you severe pain. To a physical therapist, pain is the smoke. Your pain is saying something is wrong, but it isn’t necessarily the root cause – or in this case, the fire.

Dry needling can help to alleviate the smoke (or pain), but it is only in conjunction with other techniques and assistance from your physical therapist that you can find and put out the fire.

So how does dry needling help to lessen the smoke and find the fire?

One of the primary benefits you’ll feel is pain reduction. By targeting and resetting muscles to optimal performance, it can help alleviate chronic or new, onset pain.

You may also feel improved muscle function from reduced muscle tension and improved flexibility. This can be beneficial for athletes or individuals recovering from an injury.

By addressing tight and underperforming muscles and trigger points, dry needling can help improve the range of motion in affected areas. This can be especially useful for patients dealing with joint stiffness or restricted movement.

For individuals recovering from injuries, dry needling can speed up the healing process. The technique promotes blood flow and stimulates the body’s natural healing mechanisms, leading to faster recovery times.

A group of adults hiking and smiling through the woods.

Getting back to life

A patient can become a candidate for dry needling if their physical therapy treatment needs a boost. That is, if the patient has prolonged pain and discomfort or continued muscle dysfunction.

Again, dry needling is never forced on the patient, and is used as a complement to other treatments during a plan of care.

Our approach can be a quicker return to your goals and life. At an initial consultation, a physical therapist will get an idea of what goals you have and what activities you want back in your life, whether it’s being able to pick up your kids without pain or being able to get out of bed without back pain.

As the treated has evolved, physical therapists have moved away from the aggressive trigger point approach that can make patients uncomfortable. Today’s approach is collaborative, not aggressive.

If a patient is interested in dry needling, a physical therapist will do a dry needle “before-and-after” assessment to get early results.

Indeed, your physical therapist will also help you determine if dry needling will be beneficial in the long-term. Dry needling treatment will not continue if it proves to be ineffective.

It’s also essential to consult with a qualified physical therapist to determine if dry needling is appropriate for your specific condition. Factors such as medical history, medications and overall health will be taken into consideration.

Dry needling is a valuable tool in the arsenal of physical therapy treatments. Its ability to alleviate pain, improve muscle function and accelerate recovery makes it an attractive option for many patients.

If you’re experiencing chronic pain and wanting to get back to your active life, consider discussing dry needling with your physical therapist to see if it is right for you.

Dry needling is not available in the states of California, Hawaii, New York, and Oregon. To see if a location near you provides dry needling, click here.

Dry needling is not recommended for women in first-trimester pregnancy, those with blood disorders vs. bleeding disorders, patients undergoing active cancer treatment, infections and others. A physical therapist will review your medical history before dry needling to see if you are a candidate.