Dry needling can relieve a range of musculoskeletal problems through the insertion of needles into taut and contracted muscles, or trigger points, with the aim of restoring their proper functions. It is relaxing and therapeutic procedure that can form part of an ongoing programme of osteopathic treatment, and is suitable for conditions such as back and neck pain, sporting injuries, and discomfort caused by poor posture.
There is a wide range of acute and chronic orthopedic and musculoskeletal conditions that can be treated through the use of dry needling, often in conjunction with an ongoing course of osteopathic treatment.
Dry needling seeks to relieve the pain caused by musculoskeletal dysfunction through relaxing muscle trigger points — these are taut bands that develop within a muscle that can occur in cases of both acute and chronic pain. Trigger points may develop in a muscle as a result of stresses such as poor posture, repetitive actions, or emotional trauma, and can refer pain and create dysfunction in other parts of the body, including severe headaches.
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The process of dry needling involves a solid filament needle being gently inserted into the painful part of the muscle (the trigger point) so as to relax or release it, with the aim of permanently reducing the associated pain and discomfort and restoring the imbalances caused by the muscle feeling taut and contracted.
Inserting a needle into the trigger point creates what is known as a twitch response — a feeling that is not dissimilar to a cramp — which means that the muscle is having a healing response to the stimulus and the chemical imbalance that created the trigger point in the muscle is being rectified. This then leads to a decrease in tension, enabling the muscle’s normal functions to be resumed.
Despite the superficial similarities, there are differences in both method and approach between dry needling and traditional Chinese acupuncture. In dry needling, the needles are slowly inserted into the body, gently manipulated, and then removed after a very short period, a process which may be repeated several times. This is unlike acupuncture, where it may be the case that needles are left in the body for some time. Additionally, dry needling is more directly concerned with treating specific neuromuscular problems that are causing pain or hindering mobility; acupuncture, generally speaking, seeks to address the flow of energy around the body and vital organs by inserting needles in established meridian points on the body.
Dry needling is a very safe and relaxing process. In some cases, a needle being inserted into a trigger point muscle can create a slight ache, but there is no sharp or excessive pain, and indeed many patients do not feel the needles being inserted at all. There are no sensations such as you might feel if you accidentally prick your finger, for instance. After a dry needling session, it may be that patients feel a little tired, as after a rigorous exercise session, but there are no lingering effects and most people are able to continue with their day (including playing sports) as normal.
Many patients respond positively to dry needling almost at once, finding that the problem muscles are less taut and contracted, and that they are able to move with more freedom; in some cases, it may take a day or two for the benefits to be felt. Generally speaking, several sessions of dry needling will be required for a lasting benefit to be felt and for the muscle fully to resume functioning normally again. This is because trigger points are often located under deep layers of muscle and so it takes several sessions for the changes in the muscle to take full effect.
Dry needling is therefore a very effective means of addressing a wide range of acute and chronic conditions that cause pain or hinder mobility, and is suitable for treating a number of musculoskeletal dysfunctions, such as: back and neck pain; hamstring problems; headaches; muscular tightness; shin splints; and sporting injuries.
Dry needling’s primarily focused on reducing pain and restoring function through the release of myofascial trigger points in the muscle.
What is a Myofascial Trigger Point?
A myofascial trigger point, also known as a knot in the muscle, is a group of muscle fibres that have shortened when activated but have not lengthened back to a relaxed state after use. A myofascial trigger point develops a sensitive nodule in the muscle (Simons, Travell & Simons, 1999). In addition to this nodule, the remainder of the muscle also tightens to compensate (Simons et al., 1999; Simons, 2002). This hypersensitivity occurs as the muscle fibres become so tight that they compress the capillaries and nerves that supply them (McPartland, 2004; Simons et al., 1999). As a result, the muscle cannot frequently move, obtain a fresh blood supply containing oxygen and nutrients, or flush out additional acidic chemicals (McPartland, 2004; Simons et al., 1999). The presence of a myofascial trigger point in a muscle can lead to discomfort with touch, movement and stretching, decreased joint motion, and even a temporary loss of coordination (Simons et al., 1999).
How Does Dry Needling Work?
Dry needling assists with decreasing local muscular pain and improve function by restoring a muscle’s natural ability to lengthen and shorten by releasing myofascial trigger points.
What Does Dry Needling Do?
When the delicate filament needle inserts into the centre of a myofascial trigger point, blood pools around the needle, triggering the contracted muscle fibres to relax. This reaction, in turn, leads to the decompression of the local blood and nerve supply. It also helps to provide those fibres with fresh oxygen and nutrients and flushing away any additional acidic chemicals.
What Causes a Myofascial Trigger Point?
A myofascial trigger point develops as part of the body’s protective response following:
- injury – the muscle will tighten in an attempt to reduce the severity of an injury;
- unexpected movements, e.g. descending a step that is lower than initially anticipated;
- quick movements, e.g. looking over your shoulder while driving;
- change in regular activity or muscle loading, e.g. an increase in the number or intensity of training sessions for sport;
- sustained postures e.g. prolonged sitting for work or study;
- nerve impingement – the muscle will tighten to protect the nerve;
- illness (bacterial or viral);
- nutritional deficiencies, or;
- metabolic and endocrine conditions.
(Simons, et al., 1999)
When Is Dry Needling Treatment Recommended?
Dry needling can assist in treatment:
- to help release myofascial trigger points (muscle knots);
- to assist with pain management, and;
- to restore movement at a joint if inhibited by myofascial trigger points.
What Will You Feel During Dry Needling Treatment?
During a dry needling treatment, you may feel a mild sensation as the needle inserts and withdraws. Patients don’t report any discomfort during needle manipulation.
A brief muscle twitch may occur during a dry needling treatment. This twitch may happen when the needle directly stimulates a myofascial trigger point.
Where Does Dry Needling Fit Within Your Rehabilitation Program?
Dry needling is one of many techniques that your physiotherapist can utilise to assist with your rehabilitation. We combine dry needling with other physiotherapy techniques, including massage, manual therapy, and exercise prescription.
What are the Side Effects of Dry Needling?
Every form of treatment can carry an associated risk. Your physiotherapist can explain the risks and determine whether dry needling is suitable for you based on your injury and general health.
When dry needling occurs, single-use, sterile needles are always used and disposed of immediately after using a certified sharps container.
Is Dry Needling Safe?
Everybody is different and can respond differently to various treatment techniques, including dry needling. In addition to the benefits that dry needling can provide, some side effects may occur, including spotting or bruising, fainting, nausea, residual discomfort or even altered energy levels. However, these symptoms should last no longer than 24 to 48 hours after treatment.
Can You Exercise After Dry Needling?
We recommend avoiding strenuous or high impact activities immediately after dry needling to allow the body time to recover and maximise the treatment benefits.