Dry Needling for Pain Relief

For many myofascial pain sufferers, dry needling is a welcome method for relieving myofascial pain. If you are not familiar with this pain management technique, it is the insertion of very thin needles into muscle trigger points. There is no medication involved, but the needle insertion is sufficient to loosen up tight muscles and reduce pain. Among the many kinds of pain that dry needling has been used to treat are

  • Joint conditions
  • Spinal disk conditions
  • Migraines and headaches
  • Tendinitis
  • Whiplash
  • Carpal tunnel syndrome
  • Pelvic pain
  • Phantom limb pain
  • Neuralgia

Dry Needling vs. Acupuncture

Many people confuse dry needling with acupuncture, but there are some important differences. Although both practices involve the insertion of thin stainless steel needles into various points in the body, these locations are derived quite differently. Acupuncture is based on Eastern medicine which posits that there is an energy flow called chi that governs the body’s wellbeing. Practitioners of acupuncture place needles in historically-derived points that influence chi. There is considerable skepticism about acupuncture in the medical community, but a growing number of patients and doctors are encouraging pain sufferers to at least try this alternative pain management technique.

On the other hand, dry needling is based on Western medicine and scientific evidence. Instead of putting needles into points that manage chi flow, dry needling focuses on muscle trigger points.  These trigger points are where muscle tension is most severe, and inserting a needle loosens this tension.

Practitioners of dry needling as well as acupuncture must be licensed before they can practice, but dry needling practitioners are usually physical therapists or massage therapists.  However, it should be noted that there are no industry-wide standards for licensing, so it can be difficult to determine which dry needling technicians are most qualified.

In contrast, acupuncturists typically train from 3 to 4 years. Additionally, there are national board tests that acupuncturists must pass as well as ongoing instruction requirements that must be fulfilled annually to continue practicing.

Both acupuncture and dry needling are pain relief therapies, but they are applied quite differently.  Dry needling is primarily used to relieve muscle pain and cramping—although these issues may be related to many other pain conditions. Acupuncture, however, is used for many kinds of health conditions including low back pain, knee pain, headaches, menstrual cramps, nausea and allergies. 

Neither therapy has been rigorously investigated using accepted scientific protocols, but what limited evidence is available suggests that acupuncture may be more effective than dry needling for pain relief.  Additional studies are needed to confirm these conclusions.

The risks are almost identical for acupuncture and dry needling. In almost all cases, the risks are minimal and include soreness, bruising or bleeding. The only serious risk commonly associated with either practice is transmission of blood-borne pathogens, but this is only possible if needles are reused without sterilization.

How Dry Needling Is Used

Dry needling is rarely used as the primary pain relief therapy; instead, it is often only one component of a broader physical therapy program that may include therapeutic exercises, manual manipulation, and functional retraining. Most licensed dry needling technicians view this practice as a potentially miraculous methodology that has minimal risks, so should be integrated into many more physical therapy programs.

The actual procedure is relatively simple. Prior to the session, the dry needling technician will evaluate the patient. Not only will this help determine if the patient is a good candidate for dry needling, but it will also help identify key trigger points that may require treatment.

Before insertion, the clinician will palpate the muscle trigger point. Then a fine needle is inserted using a plastic guide tube.  Following insertion, which is usually painless or only minutely uncomfortable, the clinician may adjust the depth of penetration. The length of time that the needle remains inserted depends on the judgment of the technician who may allow a greater duration to provide increased effectiveness. In general, the technician may keep the needles inserted from 10 to 30 minutes.

The number of sessions depends on the exact nature of your condition, but most people typically require less than eight sessions. Most pain sufferers will notice an improvement after only two or three weekly sessions. Chronic pain sufferers usually require more sessions than patients with only acute pain.

The Mechanism Behind Dry Needling

It may sound bizarre to insert needles a few millimeters into the skin and muscle to treat serious pain conditions, but there is mounting evidence that this is actually the case. It has been theorized that the insertion of a needle initiates an immune response that promotes healing.  Although no real damage is done, your body interprets the presence of a foreign material as harmful to the surrounding tissue.

The insertion of the needle causes your body to release cytokines, substance P and Calcitonin Gene Related Peptide. In turn, this causes vasodilation, formation of blood vessels and enhanced tissue repair.

Who Is a Good Candidate for Dry Needling?

Although dry needling has proven quite effective for many pain patients, it isn’t right for everyone.  Optimal candidates may expect one or more of the following benefits:

  • Less pain—people with myofascial pain are usually good candidates for dry needling.
  • More mobility—because people with myofascial pain often suffer from diminished range of motion and mobility, dry needling may improve these kinds of conditions.
  • Less reliance on pain pills—dry needling is for people who are on over-the-counter or prescription pain medications but want to limit their dependence on them.

Certain people with the following characteristics should not undergo dry needling:

  • Needle phobia—if you have a fear of needles or a history of reacting poorly to injections, you should avoid dry needling.
  • Pregnant women—if you are in the first trimester of pregnancy, you should not participate in a dry needling session.
  • Clotting issue—people who have hemophilia or are taking blood-thinning medications should not undergo dry needling due to the heightened risk of excessive bleeding.
  • Children—the American Physical Therapy Association does not recommend dry needling for children 12 or younger.

Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care

M.D. Disclaimer: The views expressed in this article are the personal views of Robert Moghim, M.D. and do not necessarily represent and are not intended to represent the views of the company or its employees.  The information contained in this article does not constitute medical advice, nor does reading or accessing this information create a patient-provider relationship.  Comments that you post will be shared with all visitors to this page. The comment feature is not governed by HIPAA and you should not post any of your private health information.