If your physical therapist or chiropractor recently suggested a technique called dry needling to help reduce your pain, arm yourself with plenty of information about this hot trend before making a decision.
What is dry needling?
The technique, also known as “intramuscular stimulation,” involves thin needles being inserted through the skin into achy muscles or into connective tissue to help relieve neuromusculoskeletal pain or impaired movement, according to the American Physical Therapy Association (APTA).
Often described as the Western version of acupuncture, dry needling may use the same type of needle as the one used during acupuncture, but there are some key differences. According to the APTA, "The performance of modern dry needling by physical therapists is based on western neuroanatomy and modern scientific study of the musculoskeletal and nervous system. Physical therapists who perform dry needling do not use traditional acupuncture theories or acupuncture terminology." In simple terms, Qi flow doesn't factor into dry needling.
What it does
The needle kick starts the body’s own healing process, causing increased blood flow to the area and release of chemicals that are essentially the body’s natural pain killer, says Virginia Dula, a physical therapist in Arlington, Virginia, who has used trigger point dry needling for four years.
Experts say dry needling can be uncomfortable but shouldn’t be painful per se. “A twitch of the muscle occurs when a trigger point in a muscle is hit and that can cause a deep ache-like feeling,” Dula says. “Some soreness can occur, and folks need to make sure they hydrate before and after treatment.”
Risks to consider
Used mainly by physical therapists (PTs) and, in some states, chiropractors, dry needling is highly regulated at the state level. The technique has been somewhat controversial because untrained physical therapists have been performing the procedure and, in some cases, have caused serious injury, including a pneumothorax (collapsed lung).
“Each state regulates who can perform dry needling so, for example, in Washington, D.C., any PT trained can perform the technique. In Virginia, you need a physician's order, and in Florida, it is illegal for PTs to use the technique,” Dula says.
However, some PTs stress dry needling shouldn’t be a regular part of a healthcare routine.
“I treat clients with a variety of pain complaints and incorporate trigger point dry needling, especially in cases of musculoskeletal pain,” says Ashley Flores, a licensed acupuncturist in Chicago who is trained in trigger point dry needling. “I don’t generally recommend this treatment as a regular part of clients’ healthcare routine as I don’t find it to be beneficial outside of releasing trigger points and balancing muscular function.”
It’s also somewhat of a more “aggressive” technique.
“There’s potential discomfort that can go along with it,” she says. “At the same time, I will say that when called for, trigger point dry needling techniques can be incredibly effective and can relieve pain quickly and with few side effects.”
2 things do do before you dive in
Seek out an experienced practitioner. Look for a practitioner who not only specializes in dry needling but also uses other techniques, such as strengthening or stretching exercise, to help. “The goal is to use other techniques to reinforce the benefits of dry needling,” Lewis says. “In my opinion, dry needling should be a tool of a comprehensive treatment plan, and not the entire treatment itself.”
You can also search for a practitioner through institutions that train physical therapists how to do dry needling, such as Kinetacore.
Give your practitioner your full medical history. Health history matters. Before the procedure, give the physical therapist or chiropractor a rundown of your complete medical history. This procedure isn’t for everyone, says Jesse Lewis, a physical therapist experienced with dry needling. “There are certain medical conditions, including blood clotting disorders and immune system disorders, that make this inappropriate therapy,” he says.