Dry Needling for Chronic Pain

Dry Needling for Chronic Pain Dry needling sometimes referred to as “Intramuscular Stimulation or Intramuscular Manual Therapy” is a treatment using thin filiform needles to relieve muscular pain and improve movement. It treats dysfunctions in skeletal muscle, fascia and connective tissues. Needles are placed in myofascial trigger points, taut bands of skeletal muscle located within a larger muscle group (American Physical Therapy Association).

 

Dry needling is not actually an alternative treatment. It is accepted as part of modern medicine following western medicine principles.

 

Bernard, Kerrie-Ann. (2017 October 18). ptHealth/5 Reasons to Try Dry Needling for Pain Relief. Retrieved from:

https://www.pthealth.ca/blog/5-reasons-to-should-try-dry-needling-for-pain-relief/#

 

healthline/Dry Needling vs Acupuncture: Which Is Right for You?. Retrieved from:

https://www.healthline.com/health/dry-needling-vs-acupuncture#benefits-of-dry-needling

 

Dr. Axe FOOD IS MEDICINE/Dry Needling Relieves Muscle Pain & More. Retrieved from:

https://draxe.com/dry-needling/

 

American Physical Therapy Association: Move Forward Physical Therapy Brings Motion to Life/Dry Needling by a Physical Therapist: What You Should Know. https://www.moveforwardpt.com/Resources/Detail/dry-needling-by-physical-therapist-what-you-should

 

My Harris Regional/What to Expect after Dry Needling Treatments. Retrieved from:

https://www.myharrisregional.com/Content/Uploads/Harris%20Regional%20Hospital/files/What%20to%20Expect%20after%20Functional%20Dry%20Needling-CWSM.pdf

The only commonalities dry needling and acupuncture have, are they both use thin, stainless steel needles inserted into the skin to relieve pain. The difference between these two therapies is that acupuncture is about releasing a person's energy flow (or chi) along meridians, while dry needling is used to stimulate "triggering points" and relieve pain in neuro-muscular systems.

 

Dry needling has no historical ties to acupuncture, which is based on Eastern tradition (Movement Physical Therapy). Dry needling is based on Western medical research and principles. However, some people will argue that dry needling is a type of acupuncture.

 

Healthline/Dry Needling vs Acupuncture: Which Is Right for You?. Retrieved from:

https://www.healthline.com/health/dry-needling-vs-acupuncture#benefits-of-dry-needling

 

Movement Physical Therapy/History of Dry Needling. Retrieved from:

http://www.movementvail.com/history-dry-needling

Chronic Pain ResourcesMusculoskeletal diseases affect more than one out of every two persons in the United States age 18 and over, and nearly three out of four age 65 and over (Dr. John Rusin). The most common musculoskeletal conditions people seek treatment for are back pain, trauma and arthritis. Dry needling can help with all of them.

 

Some people also experience increased energy levels, along with improved appetite and sleep. In addition, dry needling may replace the need for some surgeries, and prevent the need for medication. The reason people turn to dry needling, is tight muscles and trigger points are actually invisible to X-rays, MRIs, and CTs.

 

Dr. John Rusin/DRY NEEDLING IS THE NEXT BIG THING IN PHYSICAL THERAPY. Retrieved from:

https://drjohnrusin.com/dry-needling-physical-therapy/

 

Bernard, Kerrie-Ann. (2017 October 18). ptHealth/5 Reasons to Try Dry Needling for Pain Relief. Retrieved from:

https://www.pthealth.ca/blog/5-reasons-to-should-try-dry-needling-for-pain-relief/#

 

Clough, Jamie. (2015 May 11) Sports & Spinal Physiotherapy/Your Top 6 Dry Needling Questions Answered. Retrieved from:

http://www.sportandspinalphysio.com.au/your-top-6-dry-needling-acupuncture-questions-answered/

 

  • Achilles Tendonitis/Tendinosis
  • Athletic performance
  • Arthritis
  • Back pain
  • Carpal Tunnel
  • Chronic pain
  • Complex Regional Pain Syndrome
  • Disk pathology
  • Headaches/Migraines
  • Hip and Gluteal pain
  • Joint Dysfunction  
  • Knee pain
  • Ligament Strains
  • Muscular Strains
  • Neck pain
  • Nocturnal cramps
  • Pelvic pain
  • Phantom pain
  • Plantar Fasciitis
  • Post-herpetic neuralgia
  • Sciatica 
  • Shoulder pain
  • Spinal Dysfunction
  • Tendonitis
  • Tennis/Golf Elbow
  • Trauma
  • Whiplash disorders

Dr. Axe FOOD IS MEDICINE/Dry Needling Relieves Muscle Pain & More. Retrieved from:

https://draxe.com/dry-needling/

 

Bernard, Kerrie-Ann. (2017 October 18). ptHealth/5 Reasons to Try Dry Needling for Pain Relief. Retrieved from:

https://www.pthealth.ca/blog/5-reasons-to-should-try-dry-needling-for-pain-relief/#

 

Active Spine & Sport Therapy/Trigger Point Dry Needling (TDN). Retrieved from:

https://www.activespineandsport.com/trigger-point-dry-needling-tdn/

Chronic Pain ResourcesPractitioners use filiform needles which are fine, short, stainless steel needles that don’t inject fluid into the body (healthline). The needles are disposable and are usually 0.16 mm – 0.3 mm thick and 1.5 cm - 6 cm long in size. 

 

They will stay in the skin anywhere from 10 to 30 minutes. When placing a needle in a “trigger point” or muscular knot, a person will often twitch. This is both diagnostic as well as therapeutic, because healthy muscle tissue will not “twitch” when stimulated by the needle. (Sports & Spinal Physiotherapy, 2015). After a person briefly twitches, muscle fibers in the area will relax, and inflammation will diminish.

 

The therapist or physician can feel around with the needle and get an idea of the quality of the tissues the needle is penetrating. Another thing that happens when a needle enters the skin, is the body releases cytokines, substance P and CGRP (Calcitonin Gene Related Peptide). Where the needle penetrates the skin, the body releases CGRP, which causes a cascade of reactions resulting in vasodilation, increased blood vessel formation, and increased tissue repair (Dr. John Rusin). What happens is the needle causes injury signals to be sent to the brain, creating a series of events to replace or repair damaged tissue with healthy tissue.

 

Many will notice decreased pain and improved mobility within 24 hours.

 

healthline/Dry Needling vs Acupuncture: Which Is Right for You?. Retrieved from:

https://www.healthline.com/health/dry-needling-vs-acupuncture#benefits-of-dry-needling

 

Dr. Axe FOOD IS MEDICINE/Dry Needling Relieves Muscle Pain & More. Retrieved from:

https://draxe.com/dry-needling/

 

Clough, Jamie. (2015 May 11) Sports & Spinal Physiotherapy/Your Top 6 Dry Needling Questions Answered. Retrieved from:

http://www.sportandspinalphysio.com.au/your-top-6-dry-needling-acupuncture-questions-answered/

 

Dr. John Rusin/DRY NEEDLING IS THE NEXT BIG THING IN PHYSICAL THERAPY. Retrieved from:

https://drjohnrusin.com/dry-needling-physical-therapy/

 

My Harris Regional/What to Expect after Dry Needling Treatments. Retrieved from:

https://www.myharrisregional.com/Content/Uploads/Harris%20Regional%20Hospital/files/What%20to%20Expect%20after%20Functional%20Dry%20Needling-CWSM.pdf

  • Non-Trigger Point Technique: Instead of inserting needles into the areas of pain, the practitioner will insert needles in areas around but not directly on the point of pain (healthline). This is based on the concept that the area of pain is not the only place where problems may exist. There could be a greater nerve or muscular issue.

  • Intramuscular Stimulation (IMS): A needle is inserted directly into the trigger point or taut band, which triggers the twitch response.

  • Superficial Dry Needling (SDN): A need is inserted 1-4 mm above the trigger point, and penetrates the skin at a slant, instead of straight on. This triggers several reflex analgesic mechanisms via the spinal cord and the brain (david g simons academy).

  • Intramuscular Electrical Stimulation (IMES): This is where two needles or more are placed into the taut band, and then stimulated by light TENS currents.

ScienceDirect/Dry Needling. (2013) Retrieved from:

https://www.sciencedirect.com/topics/medicine-and-dentistry/dry-needling

 

david g simons academy/Dry Needling: The Precise Trigger Point Therapy. Retrieved from:

https://www.dgs-academy.com/en/trigger-point-therapy/dry-needling/

 

healthline/Dry Needling vs Acupuncture: Which Is Right for You?. Retrieved from:

https://www.healthline.com/health/dry-needling-vs-acupuncture#benefits-of-dry-needling

Chronic Pain ResourcesA well-trained practitioner will use clean, individually packaged, single use, sterile needles, and always disinfect the needled area before proceeding. They will also wear gloves.

 

Side Effects
Some possible side effects that can occur include muscle soreness, rare cases of fatigue, dizziness, or possibly bruising. Drowsiness or dizziness only occurs in 1-3% of patients, bruising and bleeding occurs in 15-20%, and temporary pain during occurs in 60-70% of patients. Make sure to discuss any side effects with your physician.

 

The needle insertion is usually not felt, but can create a brief pain response. A severe side effect can occur, if the physician inserts a needle near the trapezius muscle piercing the lung causing a full or partial collapse. However, many physicians won’t dry needle anywhere close to the inflated lung. Dry needling is not a good choice for someone with a fear of needles or anxiety about the treatment.

 

Dr. Axe FOOD IS MEDICINE/Dry Needling Relieves Muscle Pain & More. Retrieved from:

https://draxe.com/dry-needling/

 

Clough, Jamie. (2015 May 11) Sports & Spinal Physiotherapy/Your Top 6 Dry Needling Questions Answered. Retrieved from:

http://www.sportandspinalphysio.com.au/your-top-6-dry-needling-acupuncture-questions-answered/

 

My Harris Regional/What to Expect after Dry Needling Treatments. Retrieved from:

https://www.myharrisregional.com/Content/Uploads/Harris%20Regional%20Hospital/files/What%20to%20Expect%20after%20Functional%20Dry%20Needling-CWSM.pdf

Medical doctors Janet Travell and David Simons came up with the concept of myofascial trigger point therapy in the 1940s. On a side note, Dr. Travell was well respected and was actually a physician for President John F. Kennedy. Dry needling started off with injecting substances like corticosteroids, analgesics, and saline into trigger points (Movement Physical Therapy).

Dr. Lewit published his finding in an article in “Pain” journal called, “The Needle Effect in the relief of Myofascial Pain.”

 

Dr. P. Baldry and Dr. C Gunn helped to develop the concept of dry needling in the eighties. In the early nineties, Christian Gröbli and Ricky Weismann combined Dry Needling with Travell and Simons's findings of trigger point therapy and developed a systematic Trigger Point Dry Needling concept (david g simons academy). Dry needling is a treatment used by practitioners today worldwide. It is also a popular treatment for world class athletes around the globe (Dr John Rusin).

 

Movement Physical Therapy/History of Dry Needling. Retrieved from:

http://www.movementvail.com/history-dry-needling

 

david g simons academy/Dry Needling: The Precise Trigger Point Therapy. Retrieved from:

https://www.dgs-academy.com/en/trigger-point-therapy/dry-needling/

 

Dr. John Rusin/DRY NEEDLING IS THE NEXT BIG THING IN PHYSICAL THERAPY. Retrieved from:

https://drjohnrusin.com/dry-needling-physical-therapy/

Chronic Pain ResourcesReducing Neck and Arm Pain

Researchers analyzed the results of the best clinical studies ever done for these pain areas and found dry needling to be an effective form of pain relief. The study was published in the Journal of Orthopedic & Sports Physical Therapy.

 

Reducing Shoulder Pain

Dry needling significantly reduced shoulder pain in a 2007 study published in the American Journal of Physical Medicine and Rehabilitation. In the study, 14 patients with bilateral shoulder pain and active myofascial trigger points in the bilateral muscles underwent dry needling therapy on one side and no therapy on the other side, which served as the control (Dr. Axe FOOD IS MEDICINE). Pain was reduced, and active and passive range of motion of the shoulder significantly improved.

 

Dry Needling: Deep Versus Superficial Needling
Dry needling’s success has been established in numerous studies and two comprehensive systematic reviews. Although, the deep method of dry needling has been shown to provide better results than the superficial type of treatment for pain dealing with Myofascial Trigger Points.

 

Dr. Axe FOOD IS MEDICINE/Dry Needling Relieves Muscle Pain & More. Retrieved from:

https://draxe.com/dry-needling/

 

Kalichman, Leonid PT, PhD., Vulfsons, Simon MD. JABFM (Journal of the American Board of Family Medicine)/Dry Needling in the Management of Musculoskeletal Pain. Retrieved from:

http://www.jabfm.org/content/23/5/640.full

Requirements for physical therapists to perform dry needling vary by state. You can find some of the licensure rules and regulations for various states is the USA on Dr. MA’s Integrative Dry Needling.

 

There is also a Functional Dry Needling Certification. One place that offers certification in dry needling is KINETACORE.

 

Dr. John Rusin/DRY NEEDLING IS THE NEXT BIG THING IN PHYSICAL THERAPY. Retrieved from:

https://drjohnrusin.com/dry-needling-physical-therapy/

It is also used by doctors of Osteopathic Medicine, Naturopaths, Chiropractors and sometimes physicians. Currently there is no national regulation of dry needling in the United States. Make sure you ask about credentials, education, and years of experience before moving forward with any dry needling physician. Depending on type of insurance and location, dry needling could be covered under insurance.

 

Dr. John Rusin/DRY NEEDLING IS THE NEXT BIG THING IN PHYSICAL THERAPY. Retrieved from:

https://drjohnrusin.com/dry-needling-physical-therapy/

Chronic Pain ResourcesThe first initial dry needling session it typically about an hour. First, a patient will fill out the necessary paperwork with their health history. Then, a musculoskeletal examination and assessment will be completed.

This will also help the practitioner to figure out how many dry needles need to be used, while also taking into account a person’s response. After the evaluation the practitioner will determine if the patient is a good candidate for dry needling.

 

Depending on the condition, treatments may be performed just once a week for 2-3 weeks. The majority of patients typically require eight sessions or less. People with chronic pain will require more than those with acute pain.

 

ProActive Health PLLC/What to Expect. Retrieved from:

https://www.proactivehealthmt.com/what-to-expect

 

ProActive Health PLLC/What to Expect. Retrieved from:

https://www.proactivehealthmt.com/what-to-expect

 

david g simons academy/Dry Needling: The Precise Trigger Point Therapy. Retrieved from:

https://www.dgs-academy.com/en/trigger-point-therapy/dry-needling/

 

healthline/Dry Needling vs Acupuncture: Which Is Right for You?. Retrieved from:

https://www.healthline.com/health/dry-needling-vs-acupuncture#benefits-of-dry-needling

 

Movement Physical Therapy/History of Dry Needling. Retrieved from:

http://www.movementvail.com/history-dry-needling

 

Active Spine & Sport Therapy/Trigger Point Dry Needling (TDN). Retrieved from:

https://www.activespineandsport.com/trigger-point-dry-needling-tdn/

 

Dr. John Rusin/DRY NEEDLING IS THE NEXT BIG THING IN PHYSICAL THERAPY. Retrieved from:

https://drjohnrusin.com/dry-needling-physical-therapy/

 

Dr. Axe FOOD IS MEDICINE/Dry Needling Relieves Muscle Pain & More. Retrieved from:

https://draxe.com/dry-needling/

 

Clough, Jamie. (2015 May 11) Sports & Spinal Physiotherapy/Your Top 6 Dry Needling Questions Answered. Retrieved from:

http://www.sportandspinalphysio.com.au/your-top-6-dry-needling-acupuncture-questions-answered/

 

Bernard, Kerrie-Ann. (2017 October 18). ptHealth/5 Reasons to Try Dry Needling for Pain Relief. Retrieved from:

https://www.pthealth.ca/blog/5-reasons-to-should-try-dry-needling-for-pain-relief/#

 

My Harris Regional/What to Expect after Dry Needling Treatments. Retrieved from:

https://www.myharrisregional.com/Content/Uploads/Harris%20Regional%20Hospital/files/What%20to%20Expect%20after%20Functional%20Dry%20Needling-CWSM.pdf

 

ScienceDirect/Dry Needling. (2013) Retrieved from:

https://www.sciencedirect.com/topics/medicine-and-dentistry/dry-needling

 

Body One Physical Therapy Sports Rehabilitation/Dry Needling. Retrieved from:
http://bodyonept.com/dry-needling/

 

Hsieh YL, Kao MJ, Kuan TS, Chen SM, Chen JT, Hong CZ. (2007 May) NCBI: PubMed.gov/Dry needling to a key myofascial trigger point may reduce the irritability of satellite MTrPs. Retrieved from:
https://www.ncbi.nlm.nih.gov/pubmed/17449984/

 

JOSPT (Journal of Orthopaedic & Sports Physical Therapy)/Painful and Tender Muscles: Dry Needling Can Reduce Myofascial Pain Related to Trigger Points Muscles. (2013). Retrieved from:
https://www.jospt.org/doi/full/10.2519/jospt.2013.0505

 

Kalichman, Leonid PT, PhD., Vulfsons, Simon MD. JABFM (Journal of the American Board of Family Medicine)/Dry Needling in the Management of Musculoskeletal Pain. Retrieved from:

http://www.jabfm.org/content/23/5/640.full

 

American Physical Therapy Association: Move Forward Physical Therapy Brings Motion to Life/Dry Needling by a Physical Therapist: What You Should Know. https://www.moveforwardpt.com/Resources/Detail/dry-needling-by-physical-therapist-what-you-should