1. Introduction
I am a concierge physical therapist in Phoenix and Scottsdale, Arizona. I use dry needling A LOT with my patients and clients. It is a quick and effective way to control pain. I call it “a massage but way faster.” Have you ever struggled with muscle tightness or nagging pain that just won’t go away? Dry needling might be the solution you’ve been looking for. Dry needling is the act of inserting a small solid (meaning no tube to deliver a medication) needle into a muscle to stop it from being dysfunctional. In this article, I will go over some of the ways dry needling works, and how it can help reduce or alleviate pain.
2. What Is Dry Needling?
Dry needling uses a thin, sterile needle inserted into tight or painful muscles (called trigger points) to help release tension and improve function. The theory of where to place the needle is based on modern Western medicine, not traditional Chinese medicine which relies on homeostatic points and meridians.
3. How Does It Work?
Trigger points are areas in muscle that a heightened level of nervous system activity is taking place. This is typically an area that is either more sensitive to touch, or an area that can’t turn off the signal to contract (which many patients call a “spasm”).
Dry needling has a few key physiological effects. I use the analogy of a teacher slamming their hand down on a desk in school. That single action can either wake up a sleeping student, or it can quiet down a hyper student. Dry needling is the slamming of the hand. What the clinician does after is usually put into two main buckets:
Muscle relaxation
This is the most common immediate effect. A muscle is guarding a painful joint, or it is not shutting off correctly because your brain uses it for every movement – not just what it is intended for. When we insert the needle here, it causes a disruption in the resting tension signal from the brain. Almost like if a rock was put in your shoe you would immediately change how you walk without thinking about it.
Resetting the nervous system
This is used when we don’t use a muscle quite as much as we should. It is common after surgery, when artificially created swelling causes a muscle to shut down (our natural response to swelling is to rest the area). In this case, we are hijacking biology with the surgery. Physical therapists are trained to be able to keep muscles away from their natural relaxation response. Because the swelling is a result of correcting the structure, a physical therapist will need to limit the natural responses to swelling so you have more strength and recover faster when the surgery heals. Dry needling can help us wake up muscles that are getting natural signals to shut down.
Resetting with dry needling can also be done in non-surgical rehab. Many painful motor patterns are developed because a muscle was strained and for a period did not pull its weight. If that motor pattern persists, it can put more stress on joints and other muscles. Dry needling can be used to “slam the desk” for that muscle. When combined with appropriate exercises, the muscle can start to pull it’s own weight again and offload painful joints
4. What Conditions Can It Help With?
Neck and back pain
Shoulder and hip tightness
Headaches
Sports injuries
Tendon pain (e.g. tennis elbow, Achilles pain)
Post-operative rehabilitation
- Dry needling by itself usually can’t fix these issues. Much like massage, it needs to be combined with active retraining of motor patterns for lasting results.
5. What Does It Feel Like?
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Dry needling needles are about 1/4th the width of a novocain needle you would get at the dentist office. They rarely are painful on insertion. When they are painful, it tends to alleviate within a few seconds
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Most people feel a quick twitch or a dull ache — not sharp or stabbing pain.
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The session usually lasts just a few minutes per area.
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It is common to have soreness after a dry needling session, much like a workout or a deep tissue massage.
6. Is It Safe?
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Physical therapists need to complete a doctorate degree before even being able to sit for a dry needling class. We spend years learning anatomy, dissecting human cadavers, and working directly with medically complex patients. After graduation, most certifications require 2+ years of practice before being able to take the class. At that point, all that is left to teach is how to insert the needle safely and what physiologic effects to screen for.
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An extensive medical history and physical exam should be performed before starting dry needling. Physical therapists will always integrate it into a global plan of care focused on safely achieving your goals.
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Some common side effects involve soreness, dizziness in younger athletic patients, and bruising at the insertion site.
7. Who Shouldn’t Try It? (Contraindications)
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Patients with certain medical conditions such as bleeding disorders, pregnancy, and needle phobia are not good candidates for dry needling. While patients who are pregnant can receive dry needling, most physical therapists will ask you to get clearance from your Obstetrician first.
8. What to Expect at Your First Appointment
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A comprehensive history and physical exam should be performed prior to even considering dry needling.
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You physical therapist should discuss the finding of the exam with you, and why they feel dry needling may help you.
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Dry needling should be a part of a holistic and comprehensive physical therapy plan of care. This is typically discussed at your first appointment.
9. Real Patient Results
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Ju Jitsu Fighter – Patient had a neck strain causing nerve impingement in his arm. His grip strength on his involved side was 40#, and 120# on his non-involved side. Following dry needling to his upper trapezius muscle, he had immediate return of 120# grip strength to his involved arm. He was back to fighting within 3 sessions.
- Runner with headaches and TMJ pain – She reported significant headaches with studying and running. Following 3 sessions of dry needling and targeted movement correction for her head and neck, she was back to running and studying within 2 weeks.
10. Final Thoughts
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Dry needling can be a powerful tool for relieving pain and improving how your body moves. If used correctly, it can fast forward your recovery process and keep you active.
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If you would like to try dry needling and you are in the Phoenix or Scottsdale area, feel free to schedule a consult here. You can also email me at owen@simplifymotion.com or call (602) 975-3973