What is Dry Needling?

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Provider practicing dry needling; what is dry needling?

If you suffer from headaches or migraines, low back pain, neck or shoulder pain, dry needling might be for you. If you are wondering, “What is dry needling?” we are here to help. While it might look like acupuncture, UnityPoint Health physical therapist Jodi Oakland says it’s far from the same thing. She explains how dry needling works, the top conditions it helps, what is feels like and the side effects.

What is Dry Needling?

“A specialized technique performed by a trained professional, which uses a thin filament needle that’s inserted into the skin to treat muscle and connective tissue to improve movement and reduce pain,” Oakland says.

Before you can begin, you’ll go through an evaluation to assess movement. The physical therapist will also spend time evaluating the tissue in your body to identify problem areas.

“Each muscle has its own referred pain pattern; therefore, I might not be needling in the particular area that is painful, rather the muscle from which the pain is originating. For example, if you are having headaches, they may actually be originating from trigger points in the neck and shoulder region,” Oakland says.

Sometimes, the therapist will add electrical stimulation, by sending a pulse through the needle into the muscle. However, electrical stimulation isn’t necessarily used during every dry needling procedure; it is dependent on the therapist’s discretion and how your body responds to treatment. 

“I have many people saying, ‘I’ve been to 10 specialists, and I’ve done all types of treatments, dry needling is going to be the one thing that fixes everything.’ However, it might not be. Yes, it’s a highly effective technique. However, one treatment won’t fix it all. You need to combine it with other treatment techniques at the therapist’s discretion such as; soft tissue massage, instrument-assisted soft tissue mobilization, manual techniques and therapeutic exercise, to name a few,” Oakland says.

Dry needling is often covered by insurance, but Oakland suggests you double check with your carrier before the appointment.

Does Dry Needling Hurt?

Oakland says most people don’t feel the needle being inserted into the skin. However, once the needle goes into the affected muscle, patients often describe it as a deep aching or cramping feeling.

“The clinician is looking to elicit a twitch response, which occurs when the muscle responds to the needling. A small jerk may be felt, which is the release of the trigger point,” Oakland says.

Often people report feeling the dry needling benefit right away, with the most common dry needling side effect being soreness.

“Following the needling session, I take the patient through stretching or activating the muscles. If they have continuous soreness, I recommend a hot or cold pack and continued stretching and use of the muscle or tissue,” Oakland says.

Besides soreness, Oakland says some people have a systemic response, such as perspiring, others may have an emotional response after dry needling, which the therapist will review and explain why this may happen during the session.

Top 5 Dry Needling Conditions

Oakland says dry needling can help a long list of conditions, but she highlights some she sees the most.

• Tendonitis & bursitis (breakdown of the soft tissue around muscles and bones)
• Medial & lateral epicondylitis (overuse of the forearm, including “tennis elbow”)
• Headache/migraine
• Low back pain
• Shoulder, neck and leg pain

Dry Needling vs. Acupuncture

Dry needling is not acupuncture. Acupuncture is a treatment of Eastern Oriental medicine, which seeks to alter the flow of energy, along traditional meridians, or areas of the body, for various diseases. Oakland says acupuncturists usually set the needles along the meridians and for longer duration. In dry needling, there are fewer needles used for shorter amounts of time targeting muscle and connective tissue.

“Dry needling is based on treating pain and dysfunction to a specific, identified area of the body. Those who perform dry needling have taken continuing education and are skilled and knowledgeable to properly treat the patient,” Oakland says.

Dry needling requires special training and is often performed by a physical therapist. While dry needling is a safe treatment, there are some people who shouldn’t use it. Your provider will help identify any concerns, but Oakland says it isn’t right for people with needle phobia, cognitive impairment, local or systemic infection, varicose veins or abnormal bleeding tendencies. This will be reviewed prior to signing consent forms before the procedure.