Dry needling is the use of thin needles to treat musculoskeletal pain and weakness. The needles do not inject anything (thus the term “dry”), and they are typically inserted into the painful areas within the muscles. Think about how if you grab your upper traps there tend to be tight and tender spots; these would be examples of areas dry needles would be inserted into. Once the needle is in the muscle there are two techniques that can be used to relieve the painful area. The first is called pistoning – the needle is moved in and out of the area repeatedly until the muscle twitches. The second is the use of electric stimulation with needles, which surprisingly, tends to be more comfortable for most people – leads are hooked up to one or more needles and electricity is run through them into the muscles, which results in repeated muscle contractions. With the electric stimulation, the needles are typically left in the tissue for anywhere from 1 to 10 minutes.
Importantly, dry needling is not acupuncture. Many healthcare professionals use acupuncture needles, as they are a convenient source of needles. Some techniques may look similar, but while acupuncture is based on Eastern medicine and typically requires an entirely separate education to perform, dry needling is performed solely by physicians, chiropractors, and physical therapists and is based off entirely different principles and clinical reasoning.
What Does Dry Needling Do?
While there are local effects on muscles – decreased acidity in the area, temporarily improved blood flow – the main treatment effect, in my opinion, stems from the effect on your nervous system. In this way, it’s not different than any other soft tissue work. Massage, foam rolling, lacrosse ball rolling, soft tissue scraping, manipulations, adjustments – all of it creates pain relief by stimulating nervous system feedback that changes your brain’s perception of, and input to, the muscles in the area. The dry needling, for most people, just happens to be a very potent stimulus to create this nervous system adaptation.
That being said, dry needling generally cannot permanently fix pain by itself. The stimulus from the needles tells your nervous system to tell your muscles to act more normal, thus opening up a temporary window of opportunity that can be taken advantage of and reinforced with exercise. True long term nervous system and local tissue change does not occur from dry needling alone; a stimulus from exercise is required to make a lasting, more permanent change. Dry needling can, however, significantly speed up recovery time and decrease pain more quickly than just exercise alone. It can be used as a reset button on the nervous system to make a movement pain free within minutes, and subsequently the movement can be loaded and worked into more quickly than if the pain were persistent and we just waited for it to decrease solely with exercise.
For the most part, dry needling will be used to help prepare the body and nervous system for movement and loading. For example, if somebody comes in with low back pain, a thorough evaluation will be performed which will pinpoint locations on the patient’s body that dry needling will be most effective (usually the low back, glutes, and hamstrings), dry needling with electrical stimulation will be performed in one or more spots to decrease pain and protective muscle tone, and then specific exercises will be performed to help reinforce the more normal nervous system input and to strengthen the muscles that were needled.
When is it helpful/who is it helpful for?
Dry needling is almost always helpful for somebody experiencing musculoskeletal pain. It does not improve injury healing time, but if a muscle was injured, it can make that muscle less painful while it heals. It does not change arthritis in joints, but many times arthritis related pain results in significant protective muscle tone around a joint, and changing that muscle tone to a more normal state with needling can reduce pain. It doesn’t fix the underlying causes of chronic pain disorders like fibromyalgia, but it can have a fairly long lasting positive effect on that pain that allows people to return to normal activities and combat the chronic pain with exercise. It may not decrease your stress level, but if your neck muscles tend to get tight and you get headaches that go up the back of your head and wrap around your eyes, many people can experience immediate resolution of those stress related headaches.
Dry needling is a very useful tool because in most cases it creates an immediate decrease in pain that many other tools, including medications, may not be able to match. It opens up a window of opportunity that, if taken advantage of with movement and exercise, can help create a long term change.
For questions or more info on Dry Needling…please email Dr. John Pecora at email@example.com
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