How does dry needling work? Technique & Recovery

Dry needling is an alternative treatment option for pain management. It is inspired by traditional Chinese medicine but has been adopted by many physical therapists, chiropractors, and other doctors of Western medicine.

Why does dry needling work? The sharp sensation from the dry needle being inserted into the skin travels on a specific pathway from the point of stimulation to the brain. This flow of energy seems to reduce muscle fiber pain and soft tissue pain in many patients.

Read below to find out why dry needling is becoming an important part of many sports medicine and physical therapy treatment plans across the United States, including here in Denver, Colorado.

What is dry needling?

Dry needling therapy is a treatment in which a qualified professional applies sterile needles (with no liquid inside) to certain areas of the body. Your muscle fibers may involuntarily exhibit a “local twitch response”. This is perfectly normal and often painless.

This stimulation travels to the brain through the spinothalamic pathway. The spinothalamic pathway is significant because it is one of the primary ways the brain receives and interprets noxious stimuli.

Once the signal reaches the thalamus, it is relayed to either different parts of the body or the brain.

What does the thalamus do? The main role of the thalamus is to process sensory information and send the response to the right place.

The goal of dry needling is to reset the way that structure is viewed by the brain (thalamus) and works with the surrounding structures.

Dry needling may also be called:

  • Trigger point dry needling
  • Functional dry needling
  • Intramuscular stimulation
  • Medical acupuncture
  • Westernized acupuncture

What does dry needling do to the muscle? When a dry needle is first inserted, it may briefly cause the muscle to contract, then it relaxes. Ultimately, dry needling is meant to improve overall muscle function.

12 potential benefits of dry needling:

  1. Reduces low back pain, neck pain, knee pain, shoulder pain, hip pain, myofascial pain
  2. Accelerates your body’s natural healing processes
  3. Resolves headaches, migraines
  4. Increases blood flow
  5. Increases range of motion
  6. Lowers muscle tension
  7. Treats fibromyalgia
  8. Treats plantar fasciitis
  9. Treats golfer’s elbow
  10. Treats carpal tunnel syndrome
  11. Helps with tendonitis
  12. Reduces sciatica symptoms

How long does it take dry needling to work? Although you may have some soreness after a dry needling session, pain relief usually occurs within 24-48 hours.

How does dry needling work?

Dry needling works by stimulating the brain by inserting dry needles gently through myofascial trigger points. 

A popular theory on how dry needling works is the Neuromatrix Pain Theory.

What is the Neuromatrix Pain Theory? Developed by Dr. Ronald Melzack, the Neuromatrix Pain Theory is a novel new look at how the body and brain interpret pain. 

In short, this theory states that when a pain signal is created, it’ll take whatever pathway it is supposed to into the brain. Once in the brain, it can stimulate many different areas.

This is why pain can trigger many responses, such as:

  • Hurting (somatosensory cortex)
  • Passing out/syncope (thalamus)
  • Cold sweats (hypothalamus)
  • Crying/emotional distress (amygdala)

If an area of the brain is overstimulated with pain (when sticking a body part/muscle tissue with a filament needle), the brain will respond by reevaluating how that particular structure works in conjunction with everything else around it.

A helpful analogy on how dry needling works:

If you view your nervous system like a computer, the long-term memory is in the brain, while short term information is stored in the muscle. (That’s not exactly how it works, but close enough for this example.)

When a computer performs a task over and over again, it will eventually begin to slow down and get less productive. This is because short-term memory has become overloaded and inefficient.

To get rid of bogged-down processing, you must reboot the system and clear that short-term memory. 

This is similar to how dry needling works in the human body, helping specific muscles, body parts, and your general health.

When the body resets how the needled structure should work within the system, it may cause a dull, aching sensation (during your “restart”).

Side Effects & Recovery

Potential side effects of dry needling include:

  • A short-term increase in pain
  • Bleeding
  • Bruising
  • Headache
  • Fatigue
  • Dizziness, fainting
  • Sweating
  • Skin irritation

Why is dry needling so painful? Some people find dry needling can cause some pain. Usually, if you experience pain during or after a dry needling treatment, it is short-term and indicative of the body’s natural healing processes.

Some of these side effects may occur during or following dry needling but typically resolve within a few days. After this recovery period, your body should feel even better than it did before.

Dry Needling vs. Acupuncture vs. E-stim Therapy

We now know what dry needling is. But what is the difference between dry needling, acupuncture, and e-stim therapy?

What is acupuncture? Acupuncture is the ancient Chinese practice of strategically inserting needles into your skin. 

Acupuncture may relieve pain by releasing endorphins, your body’s natural pain-killers, and/or by regulating serotonin production and release. Serotonin is a chemical in your brain that regulates mood.

What is e-stim therapy? E-stim (electrical stimulation) therapy uses mild electrical pulses to mimic neuron signals in your nervous system. E-stim therapy for muscle tone will send these signals to specific muscles and cause them to contract.

Dry needling and acupuncture can both use the same acupuncture needles (AKA filament needles, or filiform needles).

The body requires a sharp sensation to “reboot”. That’s the reason I choose to piston the needle, instead of putting the needles in and leaving them in, usually with electric stimulation.

If the goal was to use electrical stimulation to change the way the muscle tone works, you don’t need needles for that. Just use electrical stimulation pads with a high-quality stimulation machine.

This doesn’t mean the other ways are wrong, but I have personally found the sharp sensation via needle piston is most effective.

Is dry needling right for you?

Trigger point dry needling is a low-risk, low-cost, and evidence-based method for the relief of many conditions.

Dry needling actually works. This ancient Chinese treatment for chronic pain and stress relief has been shown to reduce musculoskeletal pain by targeting acupuncture points (in your skeletal muscles) with dry needles.

Physiotherapists all across the globe have started to employ this conservative treatment option for patients with chronic pain. Since athletes commonly report chronic pain, many sports medicine practitioners have welcomed the evidence-based practice with open arms.

Here at Action Spine & Sports Medicine, myself and my team utilize evidence-based treatment plans to get you back on your feet as quickly and safely as possible. Functional dry needling is a key component to my sports medicine treatment plans.

Click here or call us today at (720) 541-7098, so you can set up your appointment with Action Spine & Sports Medicine, here in the heart of Denver, CO.

Sources

  1. Dunning, J., Butts, R., Mourad, F., Young, I., Flannagan, S., & Perreault, T. (2014). Dry needling: a literature review with implications for clinical practice guidelines. Physical therapy reviews, 19(4), 252-265. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4117383/
  2. Kubo, K., Yajima, H., Takayama, M., Ikebukuro, T., Mizoguchi, H., & Takakura, N. (2010). Effects of acupuncture and heating on blood volume and oxygen saturation of human Achilles tendon in vivo. European journal of applied physiology, 109(3), 545-550. Abstract: https://pubmed.ncbi.nlm.nih.gov/20140448/
  3. Kietrys, D. M., Palombaro, K. M., Azzaretto, E., Hubler, R., Schaller, B., Schlussel, J. M., & Tucker, M. (2013). Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis. journal of orthopaedic & sports physical therapy, 43(9), 620-634. Full text: https://www.jospt.org/doi/pdfplus/10.2519/jospt.2013.4668
  4. Unverzagt, C., Berglund, K., & Thomas, J. J. (2015). Dry needling for myofascial trigger point pain: a clinical commentary. International journal of sports physical therapy, 10(3), 402. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4458928/
  5. Giamberardino, M. A., Affaitati, G., Fabrizio, A., & Costantini, R. (2011). Effects of treatment of myofascial trigger points on the pain of fibromyalgia. Current pain and headache reports, 15(5), 393. Abstract: https://pubmed.ncbi.nlm.nih.gov/21541831/
  6. Cotchett, M. P., Munteanu, S. E., & Landorf, K. B. (2014). Effectiveness of trigger point dry needling for plantar heel pain: a randomized controlled trial. Physical therapy, 94(8), 1083-1094. Full text: https://academic.oup.com/ptj/article/94/8/1083/2735599
  7. Shariat, A., Noormohammadpour, P., Memari, A. H., Ansari, N. N., Cleland, J. A., & Kordi, R. (2018). Acute effects of one session dry needling on a chronic golfer’s elbow disability. Journal of exercise rehabilitation, 14(1), 138. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5833959/
  8. Fernández-de-Las Peñas, C., Ortega-Santiago, R., Ana, I., Martínez-Perez, A., Díaz, H. F. S., Martínez-Martín, J., … & Cuadrado-Pérez, M. L. (2015). Manual physical therapy versus surgery for carpal tunnel syndrome: a randomized parallel-group trial. The Journal of Pain, 16(11), 1087-1094. Full text: https://atmis.pl/wp-content/uploads/2017/12/J-Pain-2015-16-11-1087-1094.-Manual-therapy-vs.-surgery-for-CTS.pdf

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