What is dry needling?
Dry needling involves inserting a very thin needle (similar to that of acupuncture) into tight muscles and myofascial trigger points within that muscle to help relieve tension and pain. It is hypothesised that dry needling can be used to decrease the tension in muscles and tendons, stimulate Golgi receptors and muscle spindles, deactivate trigger points, treat overactive motor points, provide growth and blood factors to hemodynamically disturbed tissues (commonly seen in Myofascial pain syndromes), reset motor points and neural control and stimulate other reflex mechanisms.
Put simply, dry needling is another treatment tool that expertly trained Osteopaths can use in an attempt to permanently reduce muscle pain and spasm, improve range of motion, and therefore improve overall function.
Why is it called “dry”needling?
It is called dry needling to distinguish it from wet needling, which involves the injection of an agent (like local anaesthetic or saline). Dry needling involves only the use of the needle with no “wet” agent.
In simple terms, how does dry needling work?
In simple terms, when the needles are precisely placed into especially tight sections of muscles, known as trigger points, they have a resetting mechanism on the nerve and pain pathways to the brain.
When pain has been around for a while the muscle will send out constant slow releasing pain chemicals, the needles give a new input to the muscle and reacts to the foreign body forcing the slow release of chemicals to stop and focus on the new input.
Aside from resetting the pain pathways it has a local effect on the muscles itself. The body’s response to the needle brings increased blood flow and healing mediators to the site of injury meaning an increased rate of healing. Another positive effect of this is that it also encourages muscle growth and therefore increased strength capability.
Or……for those who are wanting a little more advanced knowledge of dry needling
When the needles are placed into these muscular trigger points it stimulates very sensitive nerve fibres known as golgi tendons and muscle spindle fibres, this may account for the resulting muscle relaxation
Needling deactivates trigger points and overactive motor points, trigger points are exceptionally tight sections of muscle (or knots), and these points cause local restricted range of motion, increased pain sensitivity and weakness. Deactivating these trigger points provides overall greater blood flow and increases numbers of growth factor in the muscles.
The body will recognise the needle as a ‘foreign body’ this stimulates the body’s immune system and injury response, bringing white blood cells and macrophages to the site of injury, these macrophages remove fibrins and damaged cells from the muscle to increase overall health and function of the muscle, the healthy cells and fibroblasts help regenerate collagen and elastic fibres again helping to add strength. It is this ‘injury response’ which kicks the nervous system ‘reset’ into overdrive, altering the release of substance P – our pain chemical.
Will dry needling hurt?
To be completely honest, it can be uncomfortable, but only when you’re not used to it! And it’s not the sort of ‘discomfort’ you might expect when the word needle is being thrown around… Many people are afraid of a ‘needle piercing the skin’ sensation, however this is rarely felt because of the fine width of the needle. The 0.2mm needles we use are much smaller than the ones you might receive from your local GP.
The aim of dry needling is to elicit a ‘twitch response’ from the trigger point, because it is usually followed by a reflexive relaxation in the muscle (which is the whole point). The twitch response can feel like a deep throb or cramp and can sometimes cause discomfort in the referral pattern of the trigger point, however this only lasts for a few seconds and most people welcome the sensation because it feels like something is finally hitting the spot!
How is it different from acupuncture?
Whilst the needles used in acupuncture and dry needling are the same, the practice is very different. The main difference is that acupuncture is a form of traditional Chinese medicine that involves the insertion of needles into meridian points to affect the flow of ‘Qi’ (energy) in the body. It is often used to treat similar conditions to dry needling (pain/dysfunction), but it is also used to treat a whole range of other physical and psychological conditions as well.
Dry needling is based on principles of western medicine (like neurophysiology and anatomy) and is most commonly used to treat sports and musculoskeletal problems. It normally involves the insertion of needles into trigger points to ‘release’ the myofascial tension and reduce any associated pain and dysfunction.
What is dry needling useful for?
Pretty much anything you would come see us for. We use it when helping individuals with both acute and chronic pain. When clients are comfortable with needling, we commonly use it to aid in the treatment of :
- Headaches
- Neck pain & stiffness
- Back pain & stiffness
- Hip pain & tightness
- Tennis elbow
- Shoulder injuries
- Pain & tightness in hamstrings, calf and quads
- Shin splints
Is it safe?
All of our therapist who use dry needling are expertly trained Osteopaths who adopt all safety practices they have been taught during their training. The needles used are carefully selected so as to not penetrate any organs underneath the skin. Different length needles and techniques are used to optimise safety for the patient so that the needles only penetrate skin, muscle and some fatty tissue.
- The needles are all hygienically made and stored and kept in their own individual packaging
- The needles are one use only, and will be disposed straight into a sharps bin
- Our practitioners always follow safe hand hygiene to minimise any chance of contamination
Are there any side effects?
There is always potential side effects with any technique your therapist uses. Your practitioner can discuss this with you during your treatment to ensure you make an informed decision. The worst case scenario is puncture of an organ, although this is extremely rare in expertly trained dry needling practitioners. The most common side effect is nothing more than experiencing some bruising or redness around the insertion point or some aching in the muscle similar to other Osteopathic technique responses.
Who would not benefit from this or who is contraindicated?
- It is recommended that pregnant woman in their first trimester do not have Dry Needling treatments. This is because it is generally agreed that women in their first trimester have more sensitive bodies, which could react unfavourably in some circumstances. Please let your practitioner know if you are pregnant.
- Patients with acute swelling/infection – Needling will increase the chance of further infection or cellulitis
- Blood clotting disorders – not suitable for patients that have insufficient clotting factors
- Epilepsy
- Compromised immune system
- Patients who are needle phobic
Dr. Cameron Bayliss
B Hlth Sc, B App Sc (Osteopathy)
References –
Course by Dr. Jon Marshall (Osteopath and Acupuncturist) 2017 – 2019
Travell, JG, Simons, DG: Myofascial Pain and Dysfunction :The Trigger Point Manual. Vol 1, Willams & Wilkins, 1999
Richter, P: Trigger Points and Muscle Chains in Osteopathy, Thieme, New York, 2009
