Here's What You Need to Know About Dry Needling as a Physical Therapy Practice
Nov 29, 2017
This content is brought to you in partnership with OrthoCarolina, one of the nation's leading orthopedic practices with offices across the Southeast.
We've written before about the best ways to recover after exercising, and we've also gotten a few physical therapists' perspectives on the importance of stretching after running and the health benefits of yoga for athletes.
When we're talking specifically about recovering from an injury, though, we tend to turn to the physical therapy experts at OrthoCarolina. That's why we reached out to Ken Breath (PT, ATC, LAT, and Cert. DN at OrthoCarolina) about dry needling as a physical therapy practice.
Learn more from Ken, who also works with many NASCAR teams and drivers as part of the OrthoCarolina Motorsports team, about what dry needling is and how it could potentially help you if you've recently been injured or you are experiencing pain for any other reason.
What is Dry Needling?
We weren't totally sure what dry needling actually was, so we figured we should start there. Is this basically the same as acupuncture, we wondered? Not exactly.
As one OrthoCarolina blog post explains, "We use the same size needles as those used in acupuncture, but with dry needling we go after the exact point of tightness within that band of muscle tissue. Acupuncture usually focuses more on the connection between meridian points and energy in the body."
Where dry needling is a Western medicinal practice, acupuncture is traditionally an Eastern practice reflective of Chinese medicine.
"Dry Needling (DN) — meaning no medication is used—is a skilled intervention performed by a physical therapist using a thin needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular tissue, and connective tissues for the management of neuromusculoskeletal pain and movement impairments," Ken explained.
Using a "dry" (or unmedicated) thin filiform needle, a physical therapist like Ken can stimulate myofascial trigger points, usually with the goal of relieving pain or improving a patient's range of motion.
How Does Dry Needling Impact the Body & Mind?
Aside from the nuts and bolts of how dry needling treatment was actually performed on a patient, were curious about what physical and mental benefits a patient might experience after undergoing treatment.
"Inserting a needle into a hypersensitive nodule (aka active trigger point or “knot”), a localized twitch response occurs, which is a mechanical response. Dry needling also creates chemical and neurological changes," Ken said. "While the mechanisms are still being studied and validated, it is theorized that some of the nerve stimulation of the treatment actually blocks the pain stimuli from the trigger points. Improved muscle mobility combined with decreased pain can help not only the body, but also the mind."
Who Could Benefit From Dry Needling Treatment?
Now that we knew how the treatment actually worked and what impact it might have on our minds and bodies, we asked Ken what types of people should consider pursuing dry needling. Runners? Yogis? Weight lifters?
"Dry needling can benefit anyone that is having myofascial pain or trigger points, but it is only a part of the treatment. When combined with exercise and stretching, the benefits are much greater," Ken explained. "I treat many runners and cyclists who feel tightness during or after training to maximize their performance."
So, at what point (and for whom) would Ken recommend dry needling versus other physical therapy treatments?
"I recommend dry needling as a part of a comprehensive plan for pain that may not be responding to traditional stretching or soft tissue mobilization," Ken said. "Many trigger points 'break up' on their own, but for some reason some stick around and cause pain or movement dysfunction. These are the ones that typically respond the best [to dry needling], in my experience."
But even if your physical therapist recommends dry needling as part of your comprehensive pain treatment plan, don't expect that to mean you'll be getting pricked with needles on the reg. For the most part, Ken says it's not a treatment you'll need terribly frequently.
"Generally most patients respond in just a few treatments, especially if combined with a stretching and exercise program," Ken said. "Some athletes will schedule more frequent appointments as they get closer to their event. These athletes tend to be much more in tune with their bodies and small changes can have large effects on their performance and mind."
What to Know Before Your First Dry Needling Session
If you're reading this blog post because your physical therapist already recommended that you try dry needling as part of your pain management plan, and you're nervous about your first session, don't be nervous! Here's what you can expect from your first time.
"I always go over the risks, even though they are minimal, and benefits to the treatment. Of course I obtain written/verbal consent, since it is a more specialized technique," Ken said. "I explain what a trigger point is and reassure the patient that DN is a safe procedure. I explain what the patient should experience during the treatment."
Many first-timers may be worried about the procedure being painful, but that's not quite the case.
"Typically the patient will not feel the insertion of the needle itself, only the pressure of the guide tube and a little tap. If not into a trigger point, the patient may not feel anything but some small movements around the skin," Ken explained. "Once a trigger point is hit, often a quick twitch is felt in the muscle which most describe as a small, cramping sensation. It is intense but tolerable. Feedback from the patient is very important during the process which may only take 20-30 sec per trigger point, unless electrical stimulation is applied to the needles."
Once the treatment is finished, you're not off the hook quite yet. There are a few additional steps that you should take to get the most out of your dry needling session.
"Most patients will feel an immediate change in the tissue, at which time I would instruct them in some functional movements or exercises to 'retrain the brain' in the new range of motion, sort of a reset back to normal patterns," Ken said. "I encourage increased movement as they would normally do in the day, and fluid uptake (even though this has not been proven, just a good idea)."
Ken added that you may have a general fatigue or soreness afterwards. Sometimes this is a few hours later, or you might not experience it until the next day. He doesn't recommend dry needling the day of a race or competition for that reason, unless you absolutely have to.
What Physical Therapy Treatments Should You Consider? Ask the Experts
Whether you've recently experienced an injury, need help with recovery after tough workouts, or are simply experiencing chronic pain and need help managing it, OrthoCarolina can help. Make an appointment at a location near you to start getting the treatment you need.
Have you tried dry needling before? Thinking about trying it soon? We want to hear about it! Share your story with us in the comments below or at @workforyourbeer and @orthocarolina on social media.