Dry Needling 101

Dry Needling 101

June 4, 2024

Dry needling as a therapeutic intervention has increased in popularity in recent years, as it is a very effective tool used in physical therapy for pain relief and improved mobility of muscles and joints. Some people have never heard of dry needling, and some have heard about it but really don’t know much about what it is or how it works. 

So…what is dry needling?

Dry needling (AKA myofascial or trigger point dry needling) is a therapeutic intervention that relieves muscular pain and increases range of motion in the surrounding joints. Dry needling involves inserting thin filament sterile needles directly into the skin and the muscle in areas where knots of tight muscle have formed. These knots are referred to as trigger points. The needle does not contain any medication or liquid to be injected, hence the term “dry” needling. 

What are trigger points?

Trigger points are localized, tender spots within a muscle that feel like a nodule, commonly called a “knot.” This nodule usually arises from overloading a muscle, either repetitively or acutely through a quick movement or lifting a heavy weight. Trigger points can even occur from emotional stress or sustained posture/heavy load like a heavy bag resting on your shoulder for hours. When we use our muscles, the thousands of fibers within the muscle contract (move closer together) and then relax (separate out into a resting position). When a muscle is overloaded, some of the muscle fibers stay bunched together, creating a trigger point. Trigger points are common in the neck and shoulders, gluteal muscles, and calf muscles, but can occur in any skeletal muscle in the body. Trigger points can be local (causing pain at the sight of the trigger point) or referred (causing pain in an area different from where the trigger point is located). Trigger points can also be latent or active. A latent trigger point causes some dysfunction, such as stiffness or movement restriction, but is not normally painful unless it is touched. An active trigger point not only causes dysfunction but also causes pain even when not being touched. 

Is dry needling the same as acupuncture?

No. Although dry needling and acupuncture both use similar needles inserted into the body, the two techniques are very different. Physical therapists who use dry needling have different training and licensure requirements than acupuncturists. Also, the theory and mindset behind dry needling and acupuncture differ. 

Acupuncture is a type of Chinese medicine that dates back thousands of years. In acupuncture, needles are inserted at key points along energy channels called meridians throughout the body. The main idea of acupuncture is to release energy flow to improve the body’s well being, decrease pain, and bring about healing.

Dry needling is thought to stimulate the nervous system, causing a release of endorphins (feel-good neurochemicals) to relieve tension and pain and improve range of motion of the affected muscle. Dry needling is used to treat a wide variety of conditions. 

What to expect with dry needling

The first question most people ask is: Does dry needling hurt? The answer to this question will vary from person to person, as different individuals have different thresholds for pain and differing interpretations of input to the body. Some patients report feeling increased tightness and pressure, while some report pain very similar to their trigger point pain (aching, throbbing, radiating). Unlike with injections, in most cases the patient receiving dry needling will not feel the needle at all, and if they do, it will be a very brief and minor sensation. I usually tell my patients that the pain they may feel is similar to the pain they feel when someone presses on or massages the trigger point. It can feel intense, but once the intensity passes patients often report significant relief from pain, tightness, and muscle spasm. 

Another thing to be prepared for is that sometimes a muscle will contract during dry needling, which is called a local twitch response. This is very normal and indicates that the needle is in a good spot.

Possible side effects of dry needling

The most common side effects of dry needling are very minor, and include things such as soreness, bruising, minor bleeding, fatigue, or pain during or after treatment. Some people experience a feeling of being woozy or fainting, but this is short lasting and does not indicate any serious medical concerns. Pneumothorax is an extremely rare side effect that can generally be avoided by only seeking dry needling services from therapists with the proper training and certification. Your physical therapist can answer any questions you may have about the possible side effects of dry needling. 

Benefits/mechanisms of dry needling

Dry needling is known to be extremely beneficial in reducing pain and tightness caused by trigger points. Dry needling is thought to release toxins and improve circulation to promote natural healing. Dry needling causes vasodilation in the small blood vessels around the muscle, which leads to increased blood flow and causes healing chemicals to come to the area of pain and injury to reset the healing process. 

Interested in trying or learning more about dry needling? Contact Elite Muscle Recovery at (423) 228-8120 … we’d love to connect with you!