What is Dry Needling?
Dry Needling is a highly effective treatment modality employed by many Physiotherapists worldwide. This technique involves the insertion of very thin needles into the ‘trigger points’ of the targeted muscles. The needles used are solid filiform needles, that is to say they do not contain any medication, thus came the term ‘dry needling’. Dry needling is based on Western principles and is not to be confused with the Traditional Chinese Medicine technique of Acupuncture.
What is a Trigger Point?
Dry Needling is sometimes referred to as ‘trigger point dry needling’. A trigger point, more commonly referred to as a ‘knot’ in the muscle, is a small area of taut muscle tissue which commonly forms as a result of injury, overuse, muscle imbalance etc. Active trigger points often contribute to muscle pain and dysfunction.
Elevated spontaneous electrical activity results in an area of muscle being held in a contracted state leading to that feeling of tension, tightness or pain that people so often complain of. These active trigger points often contribute to muscle pain and dysfunction, and may or may not be accompanied by a limitation in movement. Trigger points can present in both acute and chronic conditions.
Dry needling works by ‘releasing’ these trigger points, thus resolving areas of muscle spasm and reducing/eliminating pain.
What does it feel like?
Your physiotherapist will select the appropriate size and thickness of needle for the desired effect. You will feel a small prick as the needle is inserted. Next, as the needle reaches the active trigger point, the patient will feel an ache in the muscle. This may be accompanied by what is referred to as a ‘local twitch response’ which is an involuntary twitch or small contraction in the muscle.
The sensation may be uncomfortable but this twitch response is actually sought out by your physiotherapist and means that you are likely to experience good relief following the treatment. Although the treatment can be uncomfortable, it is very quick to perform.
After the session
It is normal to feel some tenderness in the treated area for up to one day post treatment. People are advised to avoid intensive exercise for at least 24 hours after their treatment.
Is Dry Needling right for me?
Dry needling is a highly effective technique and may be used any case where there is an element of muscular pain and/or dysfunction. Dry needling is commonly used in the management of the following (to name but a few):
Heel and foot pain
Dry needling can be a highly effective treatment modality but it should not be thought of as a ‘miracle cure’. For best results, it is vital to adhere to any prescribed exercise plan and follow any advice given by your physiotherapist.
When should Dry Needling be avoided?
Dry Needling is not suitable for everyone and should be avoided in the following instances:
If the patient has a needle phobia.
If the patient is unwilling.
If the patient is unable to give consent.
If the patient has a history of having an adverse reaction to needles.
If the patient is on anticoagulant therapy (blood thinners).
In an area of lymphedema.
These are the absolute contraindications to dry needling. However, there are other considerations and many potential reasons your physiotherapist may choose not to use dry needling as part of your treatment plan.
What are the risks?
When dry needling is performed by a trained physiotherapist, there is very little risk associated. Single-use disposable needles are used, gloves are worn and where necessary the area to be treated is prepared with a pre-injection alcohol swab. As such, the risk of infection is extremely low. Occasionally a small bruise may develop at the needle site much as you might experience following an injection.
When treating over the thorax there is the added risk of pneumothorax. Every precaution is taken to avoid this and it should be noted that this complication is extremely rare, however, should it occur, it has the potential to be very serious. It may present as shortness of breath, pain with breathing. Should you suspect you have a pneumothorax, you should present immediately to the accident and emergency department.