Dry Needling For Rehabilitation

When you go to a physical therapist, you expect certain types of treatments – things like stretching, strength training, perhaps range of motion exercises. Patients, especially those with chronic muscle or joint pain, also might discover relief from a treatment called dry needling. Combined with other treatments, dry needling has shown to be very effective to remedy aches and pains.

Key Takeaways: Dry Needling

• Patients with chronic joint or muscle pain may find relief from dry needling treatments during physical therapy or occupational therapy.
• Physical therapists or occupational therapists use a dry needle to go directly at pain sources following evidence-based treatment guidelines.

What Is Dry Needling?

Dry needling is a medical treatment that uses very thin needles without any medication (a dry needle). Dry needling is based on a Western medical technique that involves deep palpation into muscle fibers, tendons, and ligaments and superficial palpation on the skin to locate trigger points. The trigger points are then treated with a gentle insertion of a needle into the area.

Dry needling treatments may look like acupuncture, but it differs significantly. Physical therapists or occupational therapists use a dry needle to go directly at pain sources following evidence-based guidelines, whereas acupuncture alters the flow of Qi (or energy) along Chinese meridians.

You can do dry needling and about anywhere on the body. Typically, anywhere there's tissue, bone, muscle, ligaments, you can do dry needling.

"Dry needling can be utilized for numerous musculoskeletal, neurological, acute and chronic issues," said Jason Hutchison, PT, DPT, a physical therapist at Franciscan Health Mooresville who specializes in manual therapy, which includes dry needling and joint manipulation.

Dry needling treatments are used to treat pain and dysfunction caused by myofascial trigger points (MTrPs), tension in the muscle and fascia, and neural/physiological changes in the body. Patients of any age can benefit.

What Are Myofascial Trigger Points?

Myofascial trigger points, or areas with tight muscle fibers, can occur throughout the body in any dysfunctional joint or muscle group. These trigger points can form anywhere an injury has occurred or anywhere increased tension/stress occur. Patients may be unaware that they have myofascial trigger points.

“A trigger point is defined as a taut band of tissue within a soft-tissue fiber,” explained Austin Kiel, a physical therapist at Franciscan Health Indianapolis. “The muscle is made up of a bunch of individual fibers. Those individual fibers shorten and lengthen on each other whenever you're using the muscle. If you have any pain or weakness or there's overuse or any kind of dysfunction, you're going to get some overlapping of those individual fibers, which creates that tight, palpable, sore, tender spot that is deprived of blood flow because it's kind of knotted.”

How Does Dry Needling Work?

Dry needling allows the physical therapist to reach “deeper” than other treatment options, and the needle can cause your muscles to twitch or contract, stimulating your muscles.

Turner Bales, physical therapist at Franciscan Health Outpatient Rehabilitation Services in Beech Grove, explained how dry needles work.

“Think about a muscle like a bunch of spaghetti, like if the knot is like the spaghetti,” she said. “You're inserting the needle in the knot, then that helps break that knot up and that tissue up and releases the pain and discomfort. When you stick the needle in the knot, it is kind of micro-tearing that tissue and bringing about blood flow. So that helps create healing for that tissue.”

What Does Dry Needling Feel Like?

During a dry needle treatment, physical or occupational therapists, certified in integrated dry needling, gently insert tiny needles through the skin to identify the exact source of pain and trigger a muscle response – a twitch or spasm. That response relieves pressure in the muscle and initiates the healing process.

“Dry needling can be a little uncomfortable, but it's really not that painful,” Bales said. “So while you may have a little discomfort in the beginning, it's not much more than like getting a shot.

Franciscan physical therapist Jessica Gillespie, in Lafayette, Ind., says sometimes the source of pain may be different from where it is being felt, called a referral pattern.

“We use dry needling to identify the source of the pain," she said. "The needle will elicit electrical and chemical changes that help the body heal.”

How Long Does Dry Needling Take?

Usually delivered in combination with other therapies, a dry needling treatment takes 2 to 5 minutes.

Can Dry Needling Help Pain?

The dry needle technique has been shown to be as effective as cortisone injections and traditional physical therapy treatments alike in helping reduce muscle or joint pain, encourage healing and enhance range of motion.

“You get relief from dry needling pretty instantly,” Bales said. “After maybe initial soreness for about 24 to 48 hours, you'll feel the difference very fast. In conjunction with exercise and other modalities, dry needling can be very instant.”

What Should I Expect After Dry Needling?

It’s essential to stay hydrated after dry needling treatment due to fatigue. Expect up to 24 to 48 hours of soreness.

“You might get a little bleeding with this. Typically, you don't,” Bales said. “If it is, it's barely any at all and it's easy to stop. Some people may feel sore and a little bit of bruising, maybe some prickling sensations, but other than that, not very many side effects.”

Who Should Avoid Dry Needling?

Patients who are pregnant, on blood-thinning medications, recovering from recent surgery or have immune system complications may not be recommended for dry needling therapy. Talk to your provider about what’s best for addressing your muscle or joint pain.

How Many Dry Needle Treatments Will I Need?

Dry needling can be used as part of a larger physical or occupational therapy treatment plan. Patients typically can have one to six sessions as part of your treatment plan.

“It's not typically used alone, but it's used in conjunction with other things,” Bales said. “After you've done your sessions, we might do more exercises and things to get you back to function, because that's the ultimate goal.”