Dry Needling

What is dry needling?

In simplistic terms, dry needling (DN) utilizes a very thin filament needle, which is similar to that used in acupuncture. However, DN is not considered acupuncture and is based on Western physiologic approaches. The needle is inserted into specifically designated locations depending on the individual and their injury. It is often times inserted into a taut band of tissue, which will elicit a local twitch response to allow the muscle to relax. DN is thought to work by disrupting a reflex arc of contracted tissue as well as stimulating biochemical changes to allow improved blood flow and increased healing to the area. Furthermore, we are able to reach deeper tissues not accessible by hand.

What are the similarities and differences between dry needling compared to acupuncture?

Dry needling is similar to acupuncture in the sense that a dry, solid filament needle is inserted and manipulated under the skin to release endorphins and serum cortisol for pain relief. The difference is that dry needling is based on western neuroanatomy and modern scientific study of the musculoskeletal and nervous systems. Acupuncture is based on traditional Chinese medicine (TCM). It creates balance in the body by influencing the flow of Qi (energy) in pathways called meridians to achieve pain relief and alleviate inflammation.

Are you interested in learning more about dry needling? How can dry needling specifically benefit you?

In more complex and detailed terms, dry needling (DN) alone is similar to acupuncture, however widely different in that DN is typically used to treat muscles, ligaments, tendons, subcutaneous fascia, scar tissue, peripheral nerves and neurovascular bundles for the management of a variety of neuromusculoskeletal pain syndromes. Additionally, adding electricity to DN has anecdotally provided increased effects of the DN. The mechanism of electro-dry needling (EDN), regarding the physiological effects, is still considered unclear; however, EDN has been shown to be effective at altering biochemical pathways in a painful area. Additionally, this improves microcirculation and disrupts fibrosis in chronic neurogenic pain conditions (for example, carpal tunnel syndrome or TMJ). Dry needling is certainly a lot more than sticking needles in trigger points!

DN is performed within the framework of western musculoskeletal diagnoses, not within the theoretical framework of traditional Chinese medicine (TCM), and not for the purpose of altering the flow of Qi or energy along traditional Chinese meridians. More specifically, evidence-based guidelines are utilized for needling in the treatment of specific neuromusculoskeletal conditions (not just individual muscles!) including: whiplash associated disorders, cervicogenic headaches, tension type headaches, migraine headaches, rib syndromes, facet joint syndromes, cervical radiculopathy, mechanical neck pain, carpal tunnel syndrome, shoulder impingement syndrome, lateral epicondylalgia, and temporomandibular dysfunction.

Per www.spinalmanipulation.org, brain imaging studies have demonstrated that needling of "key" distal points (not trigger points), that are perhaps in alternative locations, which stimulate the descending pain inhibitory systems or cortical areas of the brain that are involved in pain control. In other words, decreased pain based on needle placement.

It is hard to discuss DN separate from manipulations because the two are best utilized in conjunction with one another, as the most recent literature clearly supports the inclusion of cervical and thoracic HVLA thrust manipulation (Dunning et al, 2012; Cross et al, 2011; Lau et al, 2011, Gross et al., 2010; Cleland et al, 2007) for the effective treatment of cervicothoracic pain and disability. Likewise, cervical manipulation has been found to reduce headache frequency, intensity, duration, and disability associated with cervicogenic headaches in the short and long-term (Jull et al, 2002; Haas et al, 2010); and moreover, cervical, elbow and wrist manipulation have each been shown to reduce forearm pain in chronic lateral epicondylalgia syndrome (Fernandez-Carnero et al, 2008, 2009, 2011; Struijs et al, 2003). Nevertheless, within the emerging literature, the combination of spinal manipulation and dry needling is showing the most promise for "best practice" models in a variety of musculoskeletal conditions. This is the "Osteopractic" approach in essence—the combination of spinal manipulation, extremity manipulation, and dry needling for the evidence-based treatment of neuromusculoskeletal conditions.

Are you interested in learning more about dry needling? How can dry needling specifically benefit you?

Dry needling has successfully been used to treat a variety of conditions including:

  • Head and Neck Pain - including whiplash and headaches / migraines, degenerative joint disease, degenerative disk disease or osteoarthritis
  • Otological (Ear) and Opthamological (Eye) Pain - including tinnitus and eye strain
  • Dental (Teeth) and Orthodontic (Jaw and Occlusal) Pain - including cavities, temporomandibular joint (TMJ) dysfunction, tooth impaction and root problems
  • Shoulder Pain - including rotator cuff muscle tears, bursitis, adhesive capsulitis (frozen shoulder), tendonitis and impingement syndrome
  • Elbow Pain - including lateral epicondylitis (tennis elbow) and medial epicondylitis (golfer's elbow)
  • Hand and Wrist Pain - including gamekeeper's thumb, DeQuervain's syndrome, carpal tunnel syndrome, degenerative joint disease and osteoarthritis
  • Back and Hip Pain - including lumbar degenerative disc disease, arthritic changes and herniated discs
  • Knee Pain - including degenerative joint disease or osteoarthritis
  • Shin / Ankle / Foot Pain - including shin splints, gout, metatarsalgia and Morton's neuroma
  • Plantar Fasciitis (Heel Pain)
  • Acute and Chronic Tendonitis
  • Athletic and Sports-related Overuse Injuries
  • Post-surgical Pain
  • Post-traumatic Injuries, Motor Vehicle Accidents (MVA), and Work-related Injuries
  • Other Chronic Pain Conditions - including myofascial pain and myofascial pain syndrome (MPS)

References:

  1. Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals
  2. Mechanical signaling through connective tissue: a mechanism for the therapeutic effect of acupuncture
  3. Spinal Manipulation Institute: Research
To learn more about our dry needling services or request an appointment, give us a call at
(602) 826-0037