What is Dry Needling & Is It for Me?

What is dry needling and is it for me? This is a question that the practitioners who provide dry needling (DN) as a form of therapy at Ace Sports Clinic get asked almost every day. The fear evoked by the use of the word ‘needling’ will have most people thinking about the time they were waiting in line at school to get the dreaded immunization needle or perhaps the large anaesthetic needle at the dentist. It’s the same thing, right? Not quite.

The utilization of Dry Needling for musculoskeletal pathologies

Put simply, DN is a treatment technique involving the insertion of a very thin, hair-like needle through the skin and into a tender point of the body such as a myofascial trigger point (‘a knot’) of a muscle, or into other various soft tissue structures such as tendons, ligaments or around nerves without the release of a substance from the needle.^[1]

We can look at its affect on these soft tissue structures in two different ways; if a muscle is under-active or has difficulty contracting the insertion of a dry needle can help elicit a twitch response to help fire up that muscle. Conversely, if a muscle or structure is over-active, tense or tight, like when we have trigger points, it can be used to help restore a normal resting tone of that muscle and counteract this overactivity. Both affects will be elicited via a twitch response of the dysfunctional muscle. A twitch response is a quick reflex contraction or spasm-like response of the muscle lasting no more than a second.^[2] You can have multiple twitch responses before a muscle relaxes to its normal state and thus giving off this slightly painful yet super effective experience. A recent study found that DN therapy provides much faster results than manual trigger point release techniques utilizing hands and fingers presumably due to the ‘increase specificity of the stimulus’.^[3] Think of it as a precise therapy for targeting the ‘sweet spots’ of pain in muscles, whilst also being much kinder on your practitioner’s fingers.

So how does it differ to acupuncture?

This is another question we hear all the time. Although both requiring the same filament needles, acupuncture differs in that the procedure follows the insertion of needles along ancient Chinese Medicine meridian lines with the idea of balancing and restoring energy flow (‘Qi’).^[3][4] By doing so, its main aim is to treat mostly internal ailments such as digestive and reproductive problems, stress related issues, or provide allergy relief to name a few.^[4] Generally speaking during acupuncture, needles will be placed and left in these points for around 15 to 30 minutes whilst typically, DN is a very quick form of therapy lasting a few seconds or up to a couple of minutes if required.

What does dry needling actually feel like and does it hurt?

Of course everyone’s pain response is subjective and different from person to person. However, due to the thin nature of the needle and the quick application of it, you will most likely feel a sharp prick as it first passes your skin before giving off a more gentle pressure rather than an extreme pain. However, as the muscle twitches, this is where you may feel more of an uncomfortable cramping sensation that comes and goes rapidly before relaxation.  You can think of it as a really quick foot cramp you get when you accidentally curl your toes for too long, slightly distressing in nature but over swiftly with a stretch. Many people will feel a ‘heavy’ sensation in the tissue with potential post treatment soreness similar to over working a muscle at the gym. But not to worry, this won’t last more than 1 or 2 days at most and that muscle will be feeling great soon after! Of course, heat packs / ice can be used if necessary to speed up the process of recovery.

What kind of conditions or aches can DN be used for?

DN therapy with its two differing affects can treat a range of musculoskeletal complaints such as muscle strains, spasms, trigger points and general tightnesses to chronic pain, tendon dysfunctions, neurological deficiencies and headaches.^[6] DN treatment is not used in isolation and is more so a great adjunct to other manual therapy techniques such as massage and muscle energy techniques (MET).  At Ace Sports Clinic, our practitioners will undertake a thorough history, review your requirements and obtain consent before conducting DN therapy. If you haven’t given it a try yet, maybe its time to find out about the benefits dry needling may provide you!

Written by Osteopathic Manual Practitioner Yuma Hemphill

References:

1. Kalichman L, Vulfsons S. Dry needling in the management of musculoskeletal pain. J Am Board Fam Med. 2010;23(5):640‐646. doi:10.3122/jabfm.2010.05.090296

2. Hong CZ, Simons DG. Pathophysiologic and electrophysiologic mechanisms of myofascial trigger points. Arch Phys Med Rehabil. 1998;79(7):863‐872. doi:10.1016/s0003-9993(98)90371-9

3. Jan Dommerholt (2011) Dry needling — peripheral and central considerations, Journal of Manual & Manipulative Therapy, 19:4, 223-227, DOI:10.1179/106698111X13129729552065

4. Dommerholt J, Mayoral del Moral O, Gröbli C. Trigger point dry needling. Journal of Manual & Manipulative Therapy. 2006 Oct 1;14(4):70E-87E.

5. Kawakita K, Okada K. Acupuncture therapy: mechanism of action, efficacy, and safety: a potential intervention for psychogenic disorders?. Biopsychosoc Med. 2014;8(1):4. Published 2014 Jan 20. doi:10.1186/1751-0759-8-4

6. Dommerholt J, de las Penas CF. Trigger Point Dry Needling E-Book: An Evidence and Clinical-Based Approach. Elsevier Health Sciences; 2018 Jun 21.