Dry Needling, you may have heard the term before...but what is it? It is when a thin filiform needle is used to treat musculoskeletal problems. The needle is the same needle used for acupuncture. Dry needling however IS NOT acupuncture. This post is going to give you some background on the technique, what its used for, and the safety of it.
A Brief History:
Dry needling stems from traditional acupuncture. Though it has evolved away from traditional acupuncture principles. Dry needling is a modern adaptation to traditional acupuncture. Unlike traditional acupuncture which is based on balancing the "yin and yang" and the meridian lines of the body, dry needling is based on modern understanding of human anatomy and physiology. The earliest reports of dry needling dates back to 1979, and the technique has become popular and used by many modern day clinicians. There are different philosophies used by different clinicians. Some perform trigger point dry needling, some insert the needles into the muscle but not into trigger points, some piston the needle when its inserted, some leave the needle in the muscle for an extended period of time and apply electrical stimulation through the needle. There are different ways to perform dry needling and they all are beneficial for treating musculoskeletal problems.
What is dry needling used for?
Dry needling is used to address musculoskeletal problems and myofascial pain. The use of the needle will help decrease pain. Relax muscles that need to be relaxed, excite muscles that need to be "turned on" and create blood flow to stimulate healing along with a few other cellular level benefits that promote healing. Dry needling also helps the clinician correct the alignment of the body, which is then followed up with exercise to correct the movement of the individual. Dry needling, like every other "tool in the tool box" is just a tool! It is a technique which the clinician uses to obtain the response they are seeking with their treatment. Dry needling is a very effective treatment for helping you feel better! It's used on its own, with other forms of soft tissue massage, and/or with exercise to address the problems causing you pain and dysfunction.
Is it safe?
Dry Needling is 100% safe. Now, I do not suggest buying needles and dry needling yourself. It does take a trained professional to perform. There are things that can happen if the clinician is not careful. This does not make the technique un-safe, it just means you need to know and understand what your doing before you even think about attempting to perform it on someone.
In a study looking at the safety of dry needling by Brady et al in 2014, 7,629 dry needling treatments were performed. The results are below. Bleeding was the number 1 adverse affect listed and this happened 7% of the time. The bleeding they are referring to is small droplets of blood that sometime seep out of the insertion point after the needle is removed. There are areas of the body that are more prone to this happening. The bottom of your feet is a great example of an area that tends to have a few drops of blood. In this study there were no pneumothorax (collapsed lung), no fainting, no vomiting, no prolonged aggravation, and no significant serious adverse effects reported.
In another study looking at the safety of acupuncture, (Safety of Acupuncture, Kim, Medicine, 2016) (Remember it's the same needle, just different philosophy behind the use of the needle.) There were 80,523 treatments recorded and only 57 adverse events. Yes, only 57. 47 of those were when a needle was not removed by the clinician, 4 were presyncope, 4 were pneumothorax, and 2 were infection. Out of over 80k treatments only .01% saw adverse effects that were due to something besides the clinician forgetting to take a needle out.
One of the areas of the body that needs special consideration is around the thoracic cavity. This is where your lungs are. If not careful, the lungs can become punctured by the needle and may result in a pneumothorax (a collapsed lung). The symptoms of a pneumothorax are shortness of breath, chest pain, and coughing. Though this is extremely rare, its important that the patient understands that there is a risk, and what the signs are if it were to happen. This is an emergent medical situation.
There are sometimes when dry needling doesn't feel too great, there are other times when you feel absolutely nothing during treatment (but still see positive effects afterwards). This tends to be dependent on the individual, the area being needled, and the dry needling technique being used. I've had a few women describe the "pain of the needle" as a "period cramp". I have had others describe it has what rolling on a lacrosse ball feels like. The pain and feeling is different from person to person.
Dry needling is not acupuncture. It is a very safe practice and a very beneficial treatment option. If you are experiencing myofascial pain and musculoskeletal dysfunction, dry needling is a great tool that the clinician can use to get you feeling better! There are only 6 states (California, Utah, New York, Idaho, Hawaii and Florida) in which a physical therapist cannot perform dry needling. If you are in one of the other 44, you're in luck and are able to receive the treatment!
For more information about dry needling feel free to send me an email at Tancini@groundtooverheadphysicaltherapy.com . I will be happy to answer any questions that you may have.
Dr. Michael Tancini, DPT
Ground to Overhead Physical Therapy
Address: 201 S Estes Dr, Chapel Hill, NC 27514
Chapel Hill, North Carolina , Physical Therapy, Crossfit, Sports Therapy, Recovery, Rehabilitation , Movement Specialist, Knee pain, Back Pain, Hip pain, Shoulder pain, ACL Recovery Specialist
Brady S, Mcevoy J, Dommerholt J, Doody C. Adverse events following trigger point dry needling: a prospective survey of chartered physiotherapists. J Man Manip Ther. 2014;22(3):134-40.
Kim MR, Shin JS, Lee J, et al. Safety of Acupuncture and Pharmacopuncture in 80,523 Musculoskeletal Disorder Patients: A Retrospective Review of Internal Safety Inspection and Electronic Medical Records. Medicine (Baltimore). 2016;95(18):e3635.