Less Pain and Better Movement. Dry Needling is a specialized therapeutic intervention offered by some physical therapists. It is usually offered as part of a comprehensive approach to managing pain or movement dysfunction and is growing in popularity due to its level and speed of effectiveness, short downtime, and tolerance to treatment.
Our current understanding of how dry needling works is that it changes the way the muscles communicate with the brain AND how the brain communicates with the muscles. Dry needling creates an analgesic effect and helps restore normal movement patterns. Most people say their pain has decreased within 24 hours and they feel like they are “moving like [their] old self” prior to having pain.
Other benefits of dry needling may include:
Improved performance
Faster recovery from injury
Increased blood flow
Improved sense of well-being (self reported decreased anxiety and depressive symptoms)
Improved brain retraining effects/Improved nervous system regulation
Dry Needling Vs. Acupuncture
This is one of the most common questions physical therapists get about dry needling. The following bullet points will help you better understand the similarities and differences of the two techniques:
Tools: Both use the exact same “dry” needle. There is never anything injected during either treatment. The needle is the treatment.
Origins: Dry needling theory and placement is founded in Western medicine and our current understanding of the body. Acupuncture is based in Eastern medicine. Dry needling research began in the 1940s and by the 1980s, physical therapists started using the technique for its analgesic (pain-relieving) effects. This is a relatively new therapy – especially when you compare it to acupuncture’s origin, which dates back to BCE. Not surprisingly, dry needling technique and many placement points are derived from the time-tested safety and effectiveness of acupuncture.
Treatment Goals: There is some overlap with the two practices, but acupuncture’s ultimate goal is to restore energy flow while physical therapist’s goals are to decrease symptoms (usually pain) and restore function.
Technique: Both treatments penetrate the skin. Acupuncture needle placement follows meridians that allow the flow of qi. Dry needling initially focused needle placement on places of palpable “trigger points” or bands of taut muscle. Many studies have since found that the benefits of dry needling are far reaching, whether you insert the needle into a “trigger point” or not. Current dry needling practice differs from state to state but may include needle insertion into muscle, tendon or ligaments as well as “periosteal pecking” onto bone or needling more superficially into scar tissue on the skin.
Precautions: The precautions are the same for acupuncture and dry needling and the side effects are similar as well. Learn more on precautions and side effects below.
How Dry Needling Works with your Physical Therapist:
Physical Therapy dry needling law differs from state to state. House of Balance Integrative Health and PT is located in Virginia which currently allows physical therapists who are fully certified in dry needling to perform this intervention. As of July 1st, 2023, Virginia physical therapists are considered direct access providers for dry needling (You can come see us directly without a script from your physician.) If you live outside of Virginia, please check with your local physical therapist for state-specific regulations.
If you are interested in receiving dry needling, you will first be assessed for appropriateness during a comprehensive physical therapy evaluation. We will also discuss pros, cons, precautions, and contraindications to determine whether dry needling is right for you. At House of Balance PT, we can usually start this intervention the same day as the evaluation.
We generally spend 30 minutes of your treatment session doing dry needling. The remainder of the treatment may involve neuromuscular re-education, strength training, massage, education, or other treatment modalities depending on your specific needs.
Everyone’s needs are different, but most people receive 4-5 sessions of dry needling. Athletes, people who have a physically demanding occupation, or people with chronic pain may benefit from ongoing dry needling sessions for pain management and optimal performance.
Electricity: Dry Needles plus electricity may sound daunting, but it is actually a well-tolerated treatment and has been shown to be a powerful combination that produces widespread results. This is offered in some physical therapy offices but is not offered universally. It also is something you can decline.
Commonly Treated Conditions:
We are still discovering all of the benefits of dry needling. Common conditions I have used dry needling on with great success include:
Back pain
Neck pain
Headaches
Migraine
Nervous system dysfunction
Some forms of vertigo
Surgical scar tissue
Hip pain
Shoulder pain and dysfunction
Bursitis
Frozen shoulder
Rotator cuff injuries
Fibromyalgia
Joint issues
Achilles tendinopathy
Is Dry Needling Right for You?
The list above does not detail every diagnosis or condition that dry needling can help with so speak with your physical therapist to find out if it is right for you.
Dry needling isn’t for everyone and affects people differently. Some people feel great immediately after while others feel nothing or worse for 24-48 hours and then start feeling better. Few people feel no effects whatsoever. Dry needling has a compounding effect, and therefore it is recommended to commit to 3-5 sessions within a short period of time for maximum benefit. Rarely, someone has a negative reaction to this type of therapy and needs to alter the dosage or abort dry needling all together. This is a nuanced topic that your physical therapist will be able to talk through with you to create the best plan.
Precautions:
Talk with your physical therapist to see if dry needling is right for you, but general precautions include:
Pregnancy (may be advised to wait until 2nd trimester. Modifications and avoidance of certain needling points)
Phobia of needles
Highly sensitive bodies
Contraindications:
Open skin
Bleeding disorders
Infection
Cognitive impairments that prevent people from giving full consent or feedback during the treatment
*E-stim precautions include having an electrical device implanted such as a pacemaker.
Please keep in mind that the information presented are for education only. If you are interested in working with House of Balance, please book a free consultation.
Sources:
Britannica, The Editors of Encyclopaedia. "acupuncture". Encyclopedia Britannica, 14 Oct. 2024, https://www.britannica.com/science/acupuncture. Accessed 22 October 2024.
Lara-Palomo IC, Gil-Martínez E, Antequera-Soler E, Castro-Sánchez AM, Fernández-Sánchez M, García-López H. Electrical dry needling versus conventional physiotherapy in the treatment of active and latent myofascial trigger points in patients with nonspecific chronic low back pain. Trials. 2022 Mar 28;23(1):238. doi: 10.1186/s13063-022-06179-y. PMID: 35346331; PMCID: PMC8961901.
McAphee D, Bagwell M, Falsone S. Dry Needling: A Clinical Commentary. Int J Sports Phys Ther. 2022 Jun 1;17(4):551-555. doi: 10.26603/001c.35693. PMID: 35693854; PMCID: PMC9159711.
Unverzagt C, Berglund K, Thomas JJ. DRY NEEDLING FOR MYOFASCIAL TRIGGER POINT PAIN: A CLINICAL COMMENTARY. Int J Sports Phys Ther. 2015 Jun;10(3):402-18. PMID: 26075156; PMCID: PMC4458928.
Dr. Stephanie House has over 15 years of experience in the health and wellness field and currently owns her own practice as a mind-body physical therapist in Charlottesville, VA.
She holds post doctoral certifications in vestibular therapy, dry needling, yoga therapy, and pregnancy and postpartum. With extensive continued study on topics such as mind-body medicine, integrative health, breathwork, and somatic therapy, Dr. House's extensive knowledge and comprehensive approach gets to the root of movement dysfunction and pain.
If you are ready to change the way you move and feel, work directly with Dr. House or join the House of Balance Newsletter.
"I don't heal or fix people. What I do is get your body and mind to an optimal place so you can start to heal yourself. We all have a greater capacity to heal than we are led to believe. With the appropriate input and support, our bodies can do amazing things." Stephanie House, PT, Founder
For specific questions or inquiries, reach out to Dr. House directly: info@houseofbalancept.com or visit her website: www.houseofbalancept.com
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