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Dry Needling: What is it? How does it work? Can it help?

Dry Needling: What is it? How does it work? Can it help?

Written by Anna Pattison - Clinical Myotherapist | 27th February 2022

Myotherapists and Osteopaths may use a technique called dry needling to help treat our patients at the clinic. For those that have not had this performed before, I am often asked what this is, is it the same as acupuncture, does it hurt and how does it work?

What is dry needling?

Dry needling is a treatment technique where fine, single-use acupuncture needles are inserted into myofascial trigger points (painful knots in muscles), ligaments or near nerves. When performed correctly, it is a safe and effective treatment modality that can improve or restore normal tissue function and reduce pain.

What are myofascial trigger points?

A myofascial trigger point can be considered as a “hyper-irritable spot” in a skeletal muscle. These arise following an injury or as a result of repeated stress, such as repetitive movements, postural dysfunction or emotional stress. When trigger points are present, they cause the muscles to tighten, affecting normal function and possibly compressing vascular structures and nerves (causing pins & needles). They are also more acidic, sensitising the nerves and causing increased pain.


Why is it called dry needling?

In the 1940’s, Dr. Travell and Dr. Simon identified most of the trigger points located in the human body. They then treated these trigger points by injecting lignocaine (anaesthetic) to reduce pain and dysfunction. In 1979, Dr. Lewit noticed that the positive effects achieved were actually caused by the mechanical stimulation of the needle insertion alone and not the substance injected. Therefore, dry needling does not involve the injection of any substance, merely the insertion of a needle.

Is dry needling the same as acupuncture?

Dry needling does use acupuncture needles, but that is where the similarity ends. Acupuncture is based on Traditional Chinese Medicine where the purpose is to alter the flow of energy ("Qi") along traditional Chinese meridians. By contrast, dry needling is a modern, western medical intervention using an anatomical approach to guide needle placements, with the aim of restoring normal tissue function and reducing pain in musculoskeletal conditions.

How does dry needling work?

The precise mechanisms of how dry needling works are complex and not completely understood. Muscles that are contracted for long periods of time are unable to get adequate blood supply, oxygen and nutrients which allow the muscle to return to its normal resting state. Dry needling leads to vasodilatation (dilation of the vessels), thereby allowing increased blood supply and provision of oxygen and nutrients to the muscles. The stimulus of the needle is also thought to stimulate the tight muscle fibres (actin‐myosin bonds) enabling them to relax. Finally, dry needling also works to decrease pain via local and central nervous system responses. The sensation of the needle insertion stimulates the brain to release endorphins, (the body’s own pain medication) producing a short-term analgesic.


Do you need to get a “twitch” for dry needling to work?

The needle stimulation within a myofascial trigger point may elicit a local twitch response, which is characterised by a noticeable contraction. In order to elicit a “twitch”, some therapists use a fast-in and fast-out needling technique often referred to as “pistoning”. However, this repeated needle insertion often leads to added micro-trauma and post needling soreness. Recent studies show that it is not imperative to experience the “twitch” which often may not occur when performing needling

What conditions can dry needling help?

  • Acute and chronic back pain
  • Neck pain and related headaches
  • Tennis and/or Golfers elbow
  • Gluteal or piriformis pain/dysfunction
  • Shoulder pain/dysfunction
  • Hip and knee pain
  • Shin splints and/or plantar fasciitis

Is dry needling suitable for everyone?

Generally, dry needling is safe and suitable for the majority of the population.

It is however, contraindicated in people with:

  • Epilepsy
  • Cancer
  • Bleeding Disorders
  • Anticoagulant medications (blood thinners)
  • Sensory impairment
  • Patients with needle phobia
  • Patients with a history of abnormal reaction to needling or injection
  • Into an area or limb with lymphoedema

Does dry needling hurt?

The needles used for dry needling are very thin. Some patients feel a small scratch as the needle pierces the skin, but it is rarely painful when applied by an experienced practitioner. Patients may feel some local and referred sensitivity and replication of their usual pain whilst the needle is in place, but this should always remain tolerable. If the muscle is particularly tight or there is a trigger point, it can feel like a dull ache at the site of the needle, a strong ache down the referral pain pathway or pins and needles. As the needle goes into the trigger point, you may experience a “twitch response”, causing the muscle to contract, which can feel like a cramp in the muscle. It is common to feel local tenderness in the area needled in following 24-48 hours.

Some helpful tips after you have been treated with dry needling

  • Keep the body moving! (going for a light walk or gentle stretching can help reduce the soreness post needling).
  • Maintain good fluid intake for 1-2 days post needling.
  • Application of a heat pack can alleviate post needling soreness.

What are the risks?

Dry needling is certainly considered a safe treatment but like any invasive procedure, there are risks. Rarely, mild adverse effects can include minor bleeding or bruising, or an increase in discomfort during and immediately after treatment. These are likely to resolve within 1-2 days. Dry needling poses little harm to a patient in the hands of a trained therapist.

Anna Pattison is a Clinical Myotherapist that works at Canterbury Health Hub. She is available on Mondays, Thursdays and Fridays. Click here to learn more about Anna. Book online or call (03) 9836 3688 for an appointment with Anna.