Dry needling is a type of treatment where a fine needle is inserted into the skin and muscle. It uses similar needles to traditional acupuncture, however the way it's used is very different. Acupuncture uses the placement of needles to restore balance to the flow of energy through the body. Whereas, dry needling is aimed at decreasing myofascial tension at trigger points to improve muscle function.
Mechanism
Myofascial trigger points
Commonly known as "knots", myofascial trigger points are nodules of shortened muscle fibres, unable to return to a relaxed state. These trigger points become hypersensitive, restrict blood supply and oxygen to the area, and causes a build up of acidic chemicals. Due to this, other parts of the same muscle and surrounding muscles also tend to tighten to compensate. Typical symptoms that trigger points may cause include:
tenderness or discomfort to touch
pain with movement or stretching
decrease joint range
reduced coordination
How does dry needing work?
Dry needling typically inserts fine needles into the centre of myofascial trigger points to help relax the contracted muscle fibres. The relaxing of the muscle leads to decompression of local blood and nerve supply. This aids in providing the muscle fibres with fresh oxygen and nutrient, and flush away acidic chemicals that have built up in the area.
Indications for dry needling
to help release myofascial trigger points (muscle knots);
to assist with pain management, and;
to restore movement at a joint if inhibited by myofascial trigger points.
Safety
Dry needling is an invasive technique that penetrates the skin, leading to potential hazards and complications, especially related to blood-bourne pathogens. However, when safety protocols are followed, including the use of single-use sterile needles, the risk is quite low. Legally, all practitioners needs to be adequately trained in dry needling, to use it as a form of treatment with their clients.
Side effects of dry needling
While the risk of serious side effects in response to dry needling is also quite low, it is important to be aware of the potential complications.
muscle soreness
fatigue
vasovagal reaction (fainting)
bruising
infection
Contraindications: When dry needling may not be safe
The practitioner is not adequately trained
Local infection
Bleeding disorders
Pregnancy (especially during first trimester)
Recent cardiac surgery
Immunocompromised such as those suffering from cancer, and currently receiving treatment
Bottom line
Dry needling can be an effective treatment to help reduce pain, and symptoms related to myofascial trigger points. While it not often used as a stand-alone treatment, it can form part of an effective rehabilitation plan, when combined with other physiotherapy techniques and exercise prescription.
References
Cagnie, B., Dewitte, V., Barbe, T., Timmermans, F., Delrue, N., & Meeus, M. (2013). Physiologic effects of dry needling. Current pain and headache reports, 17(8), 348.
Dunning, J., Butts, R., Mourad, F., Young, I., Flannagan, S., & Perreault, T. (2014). Dry needling: a literature review with implications for clinical practice guidelines. Physical therapy reviews, 19(4), 252-265.
Kalichman, L., & Vulfsons, S. (2010). Dry needling in the management of musculoskeletal pain. The Journal of the American Board of Family Medicine, 23(5), 640-646.