Dry needling is a technique implemented by physical therapists (depending on the state) where a thin “dry” needling - one without medication or injection - is inserted through the skin and into muscle.

Dry needling is not acupuncture. Though the same type of needle is used, dry needling typically addresses pain and dysfunction using Western medicine principles rather than a meridian approach. 


What Is The Point Of Dry Needling?

The goal of dry needling is to cause some micro-trauma to the aggravated muscle in question in order to decrease muscle tension, decrease pain, normalize dysfunction of the motor endplates (the sites at which nerve impulses are transmitted to muscles), and facilitate a healing response. The goal of the treatment is similar to why you may seek out a deep tissue massage, myofascial release, or cupping. 

Should I Have Dry Needling?

You may or may not be appropriate for dry needling depending on what your physical therapist finds during the evaluation. Typically, if dry needling is recommended, it is recommended as part of a broader rehabilitation program and not a stand-alone treatment. 

How Does Dry Needling Work?

Scientific understanding of the physiological mechanisms behind “trigger points” and dry needling has yet to be fully understood by the medical community. However, the underlying theory is that “trigger points” or taut, painful bands of muscle tissue, develop due to excessive acetylcholine release from the motor endplate of the muscle. This may develop initially as a normal, protective response in the presence of actual or potential muscle damage (which may occur after a high volume of repetitive movements or lifting something particularly heavy, beyond your capacity.) The pain that is caused by “trigger points” is likely due to hypoxia (decreased oxygen due to decreased blood flow) within the area of the taut muscle fibers. This leads to a decreased pH (more acidic) environment which actives pain receptors in the muscle. Over time, consistent pain from these areas can lead to what is called central sensitization wherein your brain gets more sensitive to painful stimuli and you, therefore, begin to feel pain more often and from stimuli that didn’t use to cause you pain. 

Dry needling these myofascial “trigger points” causes an analgesic effect (pain-relieving effect) by causing muscle twitches which reduces the concentration of pain-generating substances in the area (1/2). Furthermore, it releases endogenous opioids (pain-relieving chemicals innate in your body,)  brings blood flow to the area, and facilitates a healing & tissue remodeling response. Lastly, it is theorized to reset or decrease the dysfunction caused by the excessive acetylcholine release at the muscular endplate, therefore ceasing the aggravating cause that formulated the “trigger point” in the first place.

What Is The Evidence For Dry Needling?

Like many topics in the medical community, there is evidence standing both for and against dry needling. Typically, evidence shows that it has short to medium-term effects for pain reduction, however, long-term it does not improve function or outcomes. That is why at Chapman Physical Therapy it is one part of a comprehensive physical therapy program and not look at as a cure-all intervention. 

 

  1.  Chen JT, Chung KC, Hou CR, Kuan TS, Chen SM, Hong CZ. Inhibitory effect of dry needling on the spontaneous electrical activity recorded from myofascial trigger spots of rabbit skeletal muscle. Am J Phys Med Rehabil 2001; 80: 729–35.
  2.  Ga H, Choi JH, Park CH, Yoon HJ. Dry needling of trigger points with and without paraspinal needling in myofascial pain syndromes in elderly patients. J Altern Complement Med. 2007; 13: 617– 624.