Have you heard of a technique called dry needling?
Are you wondering what this is and when it’s appropriate to use for care?
Then buckle up, babies, and keep reading!
Dry needling is a technique used in physical therapy to target trigger points in the muscle, fascia, and scar tissue.
“Wait, wait, wait, trigger point, you say? Tell me more…”
Gladly! Trigger points are taut bands in the muscle/fascia. They develop either from an acute muscle injury or from continual muscle stress. Trigger points can be painful at their sites, or they can cause referred pain to different places in the body. Referred pain basically means that the source of pain sends a signal of pain to a different region of the body. So you may feel pain in one area while the trigger point for the pain resides elsewhere. Fascinating, no?
Example 1: You pull your hamstring. Your hamstring hurts. There are now trigger points in that gorgeous hammie.
Example 2: You sit at your desk for 8 hours a day in poor posture. You feel tightness at the front of the hips. That tightness eventually devolves into pain and in the midst of that pain lie trigger points.
Example 3: You just had a baby (congrats!). Your glutes are weak and there are trigger points there. Those trigger points refer to the pain to your low back and your low back, not your glutes, is where you feel that pain.
Do all of these examples necessitate the use of dry needling?
Dry needling is a very useful tool in our toolkit, but its use depends on how patients’ bodies respond to more conservative treatment. Let’s take example 2 for instance. When this patient comes into our office, we mobilize their hips using myofascial release techniques and bands that we teach them how to use in the office, we ask that they shift to a standing desk at work, and give them new postures for when they are sitting. We lengthen and relax the muscles, teach the patient how to do this at home, and the patient both shows progress and gets significant relief after 4 visits such that we feel comfortable progressing to the strengthening phase of treatment. We do not dry needle this patient because they responded well to our other, less aggressive techniques.
But what if this patient was not progressing as efficiently as we’d hoped? Or we hit a stall where they were progressing beautifully and it stopped?
Then they might be a good candidate for dry needling.
So what would we do?
We would palpate the body to feel for trigger points (you can feel the tense tissue), and then use small needles, like acupuncture needles, to insert into the trigger points. The placement of the needles elicits a muscle twitch/contraction of the muscle which releases the trigger point and helps the muscle to relax.
This is not the best fit for every patient, especially those patients who have a phobia of or discomfort around needles. Since our aim with dry needling is to relax muscles, if a patient is afraid of needles and their nervous system perceives a threat, we will not accomplish our goal of relaxing the body, but will, indeed, create more tension.
Ultimately, the decision of whether or not to use the tool of dry needling is one between the patient and the PT. The patient knows their comfort level and the PT knows which patients’ bodies indicate that they would benefit from this treatment.
Sometimes dry needling is just the push a patient needs to get over a muscle tightness hump, and some patients’ bodies even respond well to repeated dry needling.
But it is not a one-size fits all, and that is one reason why developing an open and honest relationship founded on trust with your PT is so very important.
A quick overview of dry-needling versus acupuncture because we often get asked the difference between the two:
- Dry Needling: needles are placed based on trigger points in muscles and on pain referral patterns (remember how sometimes trigger points tell other parts of the body to feel pain)
- Acupuncture: typically, needles are placed using meridian points, in specific pathways to address pain and dysfunction.
So, simply put, acupuncture tends to follow a set map where acupuncturists needle an area based on the acupressure points that correspond to the issues being addressed, whereas with dry needling, physical therapists follow the trigger points and pain referral patterns.
Have you ever had dry-needling done? Did you find it particularly effective?
If you are dealing with pain or injury that just won’t go away, book a FREE 10-minute consult call today. We know we can help you ✨
Be empowered in education,
OrthoPelvic Physical Therapy