What is dry needling & how does it work? Your 2023 guide

Dry needling is a treatment technique often used in physiotherapy, chiropractic, and sports medicine. A form of trigger point therapy, dry needling works to reduce muscle tension and pain. The practice is often used to support an overall treatment plan – whether you have a sports injury, ongoing musculoskeletal issues, or a chronic illness, dry needling will play a role in providing pain relief, releasing muscle tension, and reducing inflammation. Regular dry needling physical therapy can help with chronic neck pain, knee pain and osteoarthritis, musculoskeletal pain, neuromuscular pain, and more.

As physiotherapists, dry needling is common practice in the Infinite Health clinics – we regularly use dry needling techniques when treating athletes, weekend warriors, office workers, and those suffering with sports injuries. However, there’s a lot of confusion and hesitation around dry needling (needles are involved, after all). Within this article, our physical therapists are going to provide a full outline of what’s involved, how dry needling works, when it may be used, and whether or not you should be concerned about short and long term risks.

So, if your physio or other healthcare professional has advised that you consider giving dry needling a crack in your next session, this guide will arm you with all of the information so that you can confidently assess whether or not this treatment is right for you.

Let’s start with the basics:

What is dry needling?

As we mentioned earlier, dry needling is a type of trigger point therapy. Trigger point dry needling therapy aims to address any tight, painful areas in the muscles by releasing ‘trigger points’ in these muscles. Trigger points may cause pain in other parts of the body and can become tense as a result of muscle overuse, a strain, or an injury.

Trigger point therapy may involve a physician using their hands or knuckles through massage, a tool, or dry needling to apply pressure the trigger point in an effort to release the ‘knot’ or tension and provide pain relief. While a bit of a sore spot (mind the pun) for most clients, trigger point therapy is extremely effective and will often offer relief from pain right away.

Dry needling is a particularly effective type of trigger point therapy as it involves stimulating the trigger point directly and precisely with a tiny, thin needle.

How does dry needling work?

Let’s get scientific – how do the needles work?

Dry needling manual therapy uses thin, stainless steel needles that are inserted directly into specific points in the muscle. Penetrating the skin, the needles stimulate the trigger point directly, causing a muscle twitch, which will help to release the cause of tension. Much like a deep tissue massage, dry needling increases the blood supply to the affected tissue.

And what does dry needling actually do? Good question. We can talk about the physiological response of inserting needles into muscles, but that probably means very little to you if all you’re concerned about is whether or not it’ll help with your specific injury.

In essence, the needles are designed to be inserted in just the right spot that is affecting an area of muscle tension. Physiotherapists and other trained physicians will use multiple dry needles across one problem area - the end result is relaxed muscle fibres, released tension, improved blood flow, and promoted healing within the area.

Dry needling can:

· Provide pain relief

· Reduce inflammation and loosen up tight muscles

· Relax muscle spasm and myofascial trigger points, improving overall mobility and function

· Increase blood flow

· Improve overall healing responses

Dry needling can be used all over the body – most commonly, it is used on:

· Neck

· Back (lower and upper)

· Shoulders

· Hips

· Upper and lower legs

· Ankles

· Thighs/ hamstring area

Isn’t dry needling the same thing as acupuncture?

No – acupuncture and dry needling are not the same thing. This is a common misconception about dry needling that needs to be cleared up. While acupuncture and dry needling both rely on the use of needles, they are very different practices. There are a number of differences between dry needling and acupuncture, including:

1. Treatment uses & methodology

Dry needling is used by physiotherapists and other allied healthcare professionals to treat muscle tension and pain. Comparatively, acupuncture is a traditional Chinese medicine technique used to help with a wide range of concerns and is based on the belief that different areas of the body are connected to energy pathways. Dry needling is a trigger point therapy focused on treating specific issues within the skeletal muscle, whereas acupuncture is said to help balance the body’s energy and promote overall health and wellbeing.

2. Needles and techniques

Another major difference between the two practices is the needles used - dry needling relies on thinner needles inserted at a shallow depth specifically in trigger points. Acupuncture involves wider needles at different trigger points on the body.

While incorrectly often used interchangeably, dry needling and acupuncture are very different; they each address different issues, are based on very different principles, and align with different approaches to treatment.

How does dry needling fit into my overall physio treatment?

If you’re here because you’ve been considering dry needling as a treatment, it’s important to note that the practice itself is often part of a more comprehensive treatment plan. For example, dry needling may be used as just one part of the rehabilitation process for a sports injury, help with myofascial trigger points, or ongoing chronic back pain.

Dry needling certain trigger points can be effective alone, but is most effective when used in combination with other techniques such as manual therapy (massage), prescribed exercises, and stretching.

Before considering dry needling, your physiotherapist will work with you to determine the best plan of attack for your specific injury. This means we’ll identify the cause of concern, any areas of weakness, and any specific goals that you may have before we recommend dry needling or any other form of trigger point therapy and treatments.

It’s important to work with a physio that you can trust for dry needling. Before jumping straight into needling trigger points, your physio should be able to provide a diagnosis and develop a comprehensive rehabilitation plan with you. Too often, people are looking for a ‘quick fix’ without addressing the root cause of the injury; resulting in you having to come back to the physio in six month’s time with the same injury or issue.

Does dry needling hurt?

Most patients will report feelings of discomfort or a very minor ‘pinch’ of pain (if any) during a dry needling session. As the needles are not designed to go very far, besides an initial sting of the needle being inserted, the procedure should be relatively pain free. It really comes down to your pain-threshold – dry needling by our physical therapists is generally well-tolerated by most of our clients.

If you are worried about potential pain or find the procedure extremely uncomfortable, it’s really important that you discuss these concerns with your physio – they can either provide alternative treatment methods or find a way to make the process more comfortable.

Are there any risks to dry needling?

In the case of short term side effects, you may experience muscle soreness after dry needling – this will be short-lived and will merely feel like your muscles are tired and sore after an afternoon in the gym.

Long term side effects of dry needling? When performed correctly, there should be no long term effects – only increased mobility and function of your muscles.

In the hands of licensed physical therapists, dry needling is incredibly safe. We mentioned earlier that you should choose the right physio to work with – this isn’t a scare tactic; we genuinely believe that dry needling is only safe and effective when completed by a qualified, experienced, and skilled physician. Working with an inexperienced or unqualified practitioner can result in the needles being misplaced or placed too deep, causing injuries (rather than fixing them!). Consider that your warning – work with the best in biz, or risk putting your body under unnecessary duress.

What kind of conditions can it help with?

Dry needling is most common used by our physical therapists to help with back pain, muscle strains, tendonitis, and specific injuries like sciatica, calf or hamstring tightness, rotator cuff or shoulder pain and injuries, hip impingement, and much more. Dry needling is not appropriate for every condition, so it will only ever be recommended in cases where our physios feel it will provide yield pain relief, released tension, and healing within the area.

All of our physiotherapists, chiropractors, exercise physiologists, and massage therapists are fully trained and qualified to provide effective dry needling services. If you’re interested in learning more about the practice or integrating it into your rehab plan – give us a shout, and we’ll be able to provide you with more information and whether or not dry needling is the best solution for your unique set of circumstances.