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What is Dry Needling?
Dry Needling is a procedure in which physical therapists use needles to alleviate trigger points, or knotted areas of muscle that develop when muscles don’t relax. It can also decrease pain and improve mobility. Your provider will sterilize the treatment area and place the needle in the right spot. You may feel a prick or slight twitch as the needle enters the muscle, which is normal.
Dry Needling can be used on muscles, tendons, and ligaments to relieve pain and tightness. It is effective for a variety of conditions including fibromyalgia, trigger point syndrome, and myofascial pain syndrome. It can also help athletes recover faster from injuries. It can also be combined with physical therapy to rebuild strength and increase range of motion. It has a low risk of complications and can be performed by a physical therapist who is trained in the procedure.
Once a provider locates the trigger point, they insert the needle directly into it. They may move the needle around a little to try and get what is called a local twitch response—a quick spasm of the muscle. This is a good sign that the muscle is reacting to the treatment and beginning to heal.
Your provider will sterilize the treatment area and then use one hand to feel (palpate) the tissue to locate the trigger point. They will then place the needle in the tissue with a plastic guide tube in order to keep it in the right position.
The needle will remain in the muscle for a few minutes, and then your provider will remove it to see how you feel. You may experience some soreness after the treatment, but this is normal and will usually last a day or two. Some people may notice bruising at the site of the treatment, which is more common in certain areas of the body.
Minor AE’s, such as bleeding and bruising, are common during and after dry needling, but major AE’s are very rare in the hands of a trained physical therapist. The variation in reported AE’s may be due to the subjective nature of what constitutes a minor AE and the differences in the technique used by different practitioners.
How it works
Dry Needling is a form of acupuncture that uses needles to break up knotted muscle areas called myofascial trigger points. These irritable bands of muscle fiber restrict movement and compress blood vessels, causing pain. They also interfere with normal function by preventing the muscles from being able to properly contract and relax.
A CMTPT (Certified Myofascial Trigger Point Therapist) has gone through thorough training to become highly skilled at using dry needling. The needles used are much finer than a typical injection or vaccine needle, and they are designed to penetrate deeper muscle tissue without harming it. They are also very flexible, which allows them to move through muscles and fascia (the thick tissue that surrounds and covers all the muscle and bone in your body). This flexibility reduces the amount of pressure needed to activate a muscle or nerve, and it allows the needle to access deeper muscle groups that are difficult to reach with other methods.
When the needle hits a trigger point, it creates an electrical reaction that causes a twitch response within the affected muscle, and this releases the trigger point. This provides instant relief and can significantly improve the function of that muscle. The benefits of dry needling are long-lasting when it is part of a comprehensive physical therapy plan that includes therapeutic exercise and manual techniques.
However, it is important to note that not everyone can benefit from dry needling. It is generally not recommended for people with certain health conditions, such as those who are taking blood thinners or have a bleeding disorder. It can also be a risky treatment for those who are prone to infections or have a needle phobia.
Preparation
If you’re considering dry needling, the first step is to talk with your physical therapist. They will discuss your health history and do a physical exam to see if this treatment is right for you. It’s a good idea to bring a list of your current medications and any previous surgeries to this appointment.
Before the treatment begins, your provider will sterilize your skin and prepare the needles. They may use their fingers to feel (palpate) the area where they plan to insert the needles, which are always single-use, sterile and disposable. They will then insert the needles into the muscle tissue to target a trigger point knot.
When the needle is inserted, you might feel a prickly sensation and a slight muscle twitch, which is normal and is a positive sign that the treatment is working. The twitch response is the muscle attempting to relax and unwind the knotted muscles.
Once the session is over, your provider will remove the needles and inspect the skin for any redness or bleeding. They will then dispose of the needles in a medical sharps container. If you were laying down during your treatment, they will instruct you to get up slowly. If you experience dizziness, they will have you sit down to rest for a while before leaving.
You might feel a little sore or have some light bruising after your treatment, but this is not uncommon and will resolve itself. It’s important to stay active and not stay too sedentary following your treatment, as this will help speed up your recovery. In addition, it’s important to drink plenty of water to stay hydrated after your session.
During the treatment
Dry needling is performed by a physical therapist (PT) with experience in manual therapy. Your PT will sterilize the area and then insert a needle into your skin and muscle with a plastic guide tube attached to the tip of the needle. The PT will feel your muscles with their hands or fingers to locate the trigger points. The PT can also use the needle to elicit a local twitch response from your muscle to confirm they are in the right place.
Using the needles can stimulate blood flow, which will help release the knots and improve muscle flexibility. This can also help increase range of motion and decrease pain.
The treatment has very few side effects, including some minor aches and soreness in the treated area. It can also cause a muscle “knot” or twitch response in the affected muscle, which is a good sign that the technique is working. Your PT may move the needle around as needed to get the best results. The needles don’t usually stay in very long, just enough to elicit the muscle response.
Functional dry needling is an effective tool in treating muscle tightness and spasms caused by trigger points. It can reduce pain, improve flexibility and speed up the body’s natural healing process. Research published in the Journal of Orthopaedic & Sports Physical Therapy (2017) [1] found that functional dry needling effectively releases muscle knots, decreasing symptoms and improving movement patterns for patients with various musculoskeletal conditions.
Post-treatment
It is normal to feel some soreness and bruising following a dry needling session. This is a result of the small trauma caused to muscle tissue with the needle and the body’s natural inflammatory response. This is why it is recommended to drink plenty of water post treatment as hydration aids in the healing process.
The soreness will improve as the knot relaxes and blood flow improves. This allows painful acidic wastes to be carried away and the muscles to get the oxygen and nutrients they need. This will also help the muscle to return to its normal resting state and reduce pain and tension. Many patients see improvement in their pain and mobility after one session of dry needling. However, some may need multiple sessions to get optimum results.
A practitioner will perform a physical exam to determine if you are a candidate for dry needling and explain how the procedure works. You will wear comfortable clothing and lie down in a private treatment room or curtained-off section of the clinic.
FDN can be used to treat a wide range of conditions and injuries, including fibromyalgia, temporomandibular joint (TMJ) disorders, cervical pain, lower back pain, headaches, sports injuries and chronic regional pain syndrome. It is usually combined with other treatments, such as manual therapy, therapeutic exercises and modalities, to achieve the best results.
The results from the studies vary widely, which is due to differences in the definitions of minor AE and the subjective nature of reporting. The authors of this study suggest that future research should establish clearer guidelines for what constitutes a minor AE and develop methods to standardize the recording of this information.