Dry needling targets muscle tissue and its nerve connections. If you have a condition where muscle pain or tightness is an issue – dry needling may be of benefit to you. These conditions may include (but are not limited to); neck tension, headaches, back pain, tennis elbow, shoulder conditions or shin pain.
Unlike the ‘set and forget’ approach of acupuncture, in a dry needling treatment the physiotherapist does not leave the patient’s side. A needle is gently inserted, moved slightly and then removed straight away. This is repeated a few times into the muscle or muscles in question
Dry needling specifically targets the trigger points in muscles. A trigger point is a hypersensitive region within a muscle (like those tender “knots” or lumps that you can feel in your muscles when you are stressed). When the needle is inserted into the trigger point, it acts to “jump start” the muscle and it’s nerve supply. This usually results in a reflex relaxation of the muscle. Often a local twitch response of the muscle will be elicited with insertion of the fine needle, which is a good indication that the dry needling session has been effective in relieving muscle tension and may also activate the body’s release of it’s natural painkillers – endorphins and serotonin.
In this article, the team at BodyMotion Physio explores the question, ‘what is dry needling?’ in more detail, as well as how dry needling works, what it’s good for, and any associated risks.
What’s the difference between dry needling and acupuncture?
What’s the difference between acupuncture and dry needling? They actually have parallel features as both therapies involve inserting thin needles into areas of the skin to relieve symptoms and discomfort. While they can look similar, the techniques facilitate relief in different ways.
Dry needling targets strained trigger points to improve blood supply and stimulate the brain by making it believe the body is ‘under threat’ from the needles entering the skin. In response, the brain blocks passages of discomfort to the body, resulting in relieving headaches, neck tension, shoulder issues, knee problems, tennis elbow and many other musculoskeletal issues (1).
Acupuncture, on the other hand, aims to relieve pain differently; by inserting filiform needles into the skin to unblock ‘qi’ energy. When qi is flowing appropriately, the body is more balanced and health issues are prevented. Traditional Chinese medicine professionals believe that balancing qi and promoting the healthy flow of the body’s energy enhances relaxation and stimulates healing.
More generally, acupuncture was born from traditional Chinese medicine, and it targets acupoints to harness channels within the body. Dry needling, however, is derived from Western anatomical principles and the needles targets areas more relevant to modern medical science and research.
How does dry needling work?
If you’re concerned with how does dry needling work, there is no reason to fret. Dry needling targets specific trigger points that cause pain and discomfort in the body. Modern science explains that when muscles are strained or overused, they form myofascial trigger points, which many people refer to as ‘knots’ (5). When knotted, these muscles do not receive the amount of blood needed to relieve the stress, and the associated lack of oxygen leaves your muscles incapable of returning to their natural resting state.
Without balanced oxygen and nutrient flow, the problems in these muscles compound to become more acidic, causing pain or discomfort. As such, dry needling applies filament needles directly to these trigger points, and the stimulation helps blood to flow back to the affected area (5). This flow can flush out the impurities or acids and release tension and discomfort. In addition, the intrusion of the needle causes the brain to release endorphins and act as instant, natural pain relief.
How do physiotherapists find trigger points?
Therapists are trained in trigger point maps that locate common areas of the body where trigger points often develop, but because every patient has a unique build, this is just a guide. Before a dry needling session, a therapist will examine the area with their hands and use their experience in locating trigger points to determine where they will insert the needles.
What happens when trigger points are targeted?
During the session, the therapist inserts needles directly into these trigger points, with some back-and-forth movements. By moving around as they insert the needle, the therapist is trying to elicit a minor muscle spasm, scientifically referred to as a local twitch response. This means the muscle is reacting to the treatment and is a sign that it’s working effectively (2). Therapists repeat this for all of the trigger points located within the session.
Many patients report instant relief and improvement in movement after their session as the blood is able to enter the area again and release the muscle strain. However, in more severe cases with several or more advanced trigger points, additional dry needling sessions are required for adequate relief.
What does dry needling feel like?
Contrary to what you might imagine piercing your skin with several needles feels like, most patients feel minimal discomfort and little to no pain. Due to the size of the needles, a sharp sensation is often felt as they enter the skin followed by feelings similar to a slight muscle cramp as the local twitch response is triggered and the muscles contract. All of these sensations are harmless and actually a desirable outcome as it means the muscles are reacting appropriately.
More generalised sensations during treatment include relaxation of the area or heaviness in the limbs. After treatment, patients might experience muscle soreness for up to 48 hours as well as redness in the treated areas.
When will I feel better?
Some people will feel better straight away, whereas others may feel better a day or two later. If you believe you have not felt much change, you may respond better to manual massage therapy from the Physiotherapist instead. If your condition is ongoing/chronic, regular dry needling may be an effective way of managing, reducing or eliminating your pain.
For the rest of the day after a dry needling session, your muscles might feel achy and tired, a bit like how you feel after you’ve done a big workout at the gym. It’s a good idea to drink plenty of water and rest if you feel tired. If you are already used to the needling, it should be fine to continue your normal training/exercise regime that day, but after your first time, you may choose to take a day off.
For the majority of people a course of 3 – 6 treatments can make considerable changes in muscle tension.
What is dry needling good for?
As dry needling is effective at releasing the tension of trigger points and helping blood to flow back to these areas, the treatment is great for many issues that result from strained muscles. Studies show that dry needling not only increases the blood flow to these areas, but also decreases banding of the targeted muscles, decreases spontaneous electrical activity, and provides beneficial biomechanical changes (5).
What those improvements translate to are help with:
- Patients with musculoskeletal problems, such as:
- Shoulder tension
- Muscle pain
- Neck, hip, ack and heel pain
- Relieving muscle strain and stiffness and improving range of motion
- Athletes who want to recover quickly from intense sports sessions or treat acute injuries
- Chronic myofascial symptoms, such as:
- Insertion tendinopathy
- Cervical, thoracic or lumbar spine syndrome
- Visceral pain
- Tension headaches
What role does dry needling play in rehabilitation?
As dry needling provides a range of benefits, it can play multiple roles in the rehabilitation of acute injuries and muscle or joint issues. Many physiotherapists will recommend patients have a dry needling session at the start of treatment to reduce the discomfort and pain of the injury while improving blood flow to initiate healing early.
After an initial session, other effective treatments are likely to be introduced to aid healing. Dry needling can work in conjunction with other treatments to continue positive biochemical changes, increasing blood flow and reducing tension in the area. Depending on the injury, dry needling can help relieve pain and promote health, but it may not be effective at eliminating the source of the problem, which is why it works well with other treatments.
Is dry needling safe?
While dry needling is a completely safe treatment, as with many alternative treatments, safety concerns may arise for those unfamiliar with it. Luckily, many studies have been performed to evaluate how safe the treatment is as well as methods to enhance safe dry needling applications. These studies show that when dry needling is executed in line with certified training – including the best practices of techniques and hygiene – and performed accurately by an experienced clinician, dry needling risks are minimal (3).
While slight bleeding and bruising can occur, experienced clinics that harness clean techniques can ensure this occurs very rarely. The primary dry needling risks arise from the treatment being performed by a non-certified practitioner, as clinicians have to understand how to locate trigger points, the force at which to apply the needles, and the appropriate equipment to use to ensure your treatment and care are effective and safe.
When dry needling is performed with a poor technique, the most serious problem that occurs is pneumothorax, caused by the needle being inserted into the trapezius muscle too deeply and partially collapsing the lung. Many clinicians will avoid this avoid area, however, as most physiotherapists have an advanced understanding of anatomy and techniques (4).
Is Dry Needling for me?
Although the use of Dry needling may be an attractive and effective alternative to traditional muscle release/myofascial release techniques, it is not for everyone. Please consult one of our Physiotherapists so that they can work with you to assess your suitability for treatment.
If you would like to find out more about dry needling, how it works, and what it’s good for, or you would like to book in for an appointment with one of our physiotherapists, please just give us a call on (03) 9873 3333
1: Dunning, J., Butts, R., Mourad, F., Young, I., Flannagan, S. and Perreault, T., 2014. Dry needling: a literature review with implications for clinical practice guidelines. Physical Therapy Reviews, [online] Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4117383/> [Accessed 24 March 2022].
2: Roland Gautschi, in Myofascial Trigger Points, 2013 https://www.sciencedirect.com/topics/medicine-and-dentistry/dry-needling
3: Rodríguez-Sanz J, Pérez-Bellmunt A, López-de-Celis C, et al. Accuracy and safety of dry needling placement in the popliteus muscle: A cadaveric study. Int J Clin Pract. 2021;75:e14669. https://doi.org/10.1111/ijcp.14669
4: Sport Australia. 2022. Dry Needling. [online] Available at: <https://www.ais.gov.au/position_statements/best_practice_content/dry_needling> [Accessed 24 March 2022].
5: E. Zylstra DPT, K.R. Maywhort DPT, in Orthopaedic Physical Therapy Secrets (Third Edition), 2017 https://www.sciencedirect.com/topics/medicine-and-dentistry/dry-needling