Dry Needling

Getting to the point of your pain and movement dysfunction.

Functional Dry Needling (FDN) is an effective therapy that treats muscular tension and spasm produced by myofascial trigger points. Trigger points are painful “knots” in taught bands of impaired muscles that play a role in producing and maintaining a pain cycle.

How Does Dry Needling Work?

When an injury occurs from repetitive use or acute trauma, inflammation will be produced from the damaged tissues.  The damaged tissues will also go into a protective tension state or contracture to guard against further damage from utilizing the injured tissue leading to compression and irritation of nerves.

Dry needling involves identifying the source of the pain and advancing thin, solid filament needles into the related muscles to stimulate underlying neural, muscular and connective tissues. Research shows that the strategic insertion of the needle creates a quick muscle twitch stimulating the body’s natural healing capabilities, increasing blood flow and oxygen circulation to the area, decreases muscle contraction, reduces chemical irritation and improves flexibility, pain and dysfunction. This process essentially “reboots” the muscle and the decrease in pain is related to the removal of muscular compression on joint, nerve and vascular tissue.

Sometimes the insertion of the needle will also reproduce “referred pain” symptoms. This is often a positive sign confirming the trigger point as being the cause of the pain. Many patients experience dramatic pain relief and improved function in just a few treatments often with lasting relief.

Benefits of Dry Needling

  • Natural Pain Reliever
  • Restores motion and function
  • Reduces muscle tension and trigger points (muscle knots)
  • Desensitizes irritated tissues
  • Increases blood flow & Initiates tissue healing
  • Normalizes biochemical and electrical dysfunction of motor end plates
  • Accelerates return to active rehabilitation

    Who Can Benefit?

    • Those who suffer from:
    • Neck pain
    • Low back pain
    • Muscle strains
    • Headaches/migraines
    • Sciatica
    • Arthritis
    • Stenosis
    • Tendonitis
    • Osteoarthritis
    • Bursitis
    • Carpal tunnel syndrome
    • Plantar fasciitis
    • Shin splints
    • Fibromyalgia
    • Athletic Performance
    • And many others

    Frequently Asked Questions

    Will all patients receive Dry Needling?

    Dry Needling will not replace our typical physical therapy treatment and will only be utilized as an adjunct therapy for patients interested in the technique. It is another very specific tool to help reduce patients’ pain which will then allow the patients to tolerate their exercises much better.

    Is Dry Needling Painful?

    Typically, patients will feel pain but it is short-lived. The twitch response elicits a very brief cramping and/or deep aching sensation. FDN may reproduce symptoms directly in the muscle being treated or may refer to other areas of the body. Generally, the level of pain does indicate the level of relief the patient will feel following treatment. Treatment will always be based upon the patient’s tolerance and consent.

    Is Dry Needling safe?

    Our Doctors of Physical Therapy who have completed extensive hours of training and years of education based on anatomy and neuromusculoskeletal conditions will go to great length to ensure safety. We apply OSHA standards, use personal protective high-quality equipment, only use the highest quality sterile disposable needles and have a very high standard of safety.

    Is Dry Needling different from Acupuncture?

    FDN is not acupuncture or Oriental Medicine; that is, it does not have the purpose of altering the flow of energy (“Qi”) along traditional Chinese meridians for the treatment of disease. In fact, FDN is a modern, science-based intervention for the treatment of pain and dysfunction in musculoskeletal conditions by Doctors of Physical Therapy who have a thorough knowledge and understanding of your condition based on their extensive professional evaluations and assessments they conduct. Unlike acupuncture sessions, which can involve dozens of needles in several areas of the body, dry needling often utilizes just a few needles that are strategically placed along affected muscles.

    Are there any side effects?

    There may be some soreness immediately after treatment in the area of the body that lasts between a few hours and 2 days, and there is occasional bruising.  Typically, it feels like you have had an intense workout at the gym, but a small number of patients report drowsiness, tiredness, or dizziness (1-3%).  Soreness may be alleviated by applying ice or heat to the area and performing specific stretches for the treated muscle.

    How many sessions of Dry Needling will I need?

    We are looking to get improvements even from the first visit such as increased range of motion, ease of movement and decreased symptoms, but complete restoration of the muscle dysfunction is based on the chronicity and severity of your condition. We will only dry needle the same muscle group 1 time per week to allow for completion of the physiological immune response with dry needling.

    The Science Behind Dry Needling

    When an injury occurs from repetitive use or acute trauma, inflammation will be produced from the damaged tissues. The damaged tissues will also go into a protective tension state or contracture to guard against further damage from utilizing the injured tissue. This contracture and inflammation inhibit microcirculation which limits both the oxygen rich blood reaching the injury and the waste products leaving the injury. The injury site becomes hypoxic (decreased in oxygen) which stimulates the body to produce fibroblasts, a cell that produces fibrosis or scar tissue. This fibrosis and scarring builds up around the muscles and tissues limiting the tissues ability to fully function (lengthen/shorten) and can also cause compression and irritation of nerves (such as carpal tunnel syndrome) – all of which inevitably lead to biomechanical disturbances in gait and function.
    Functional Dry Needling uses a small, solid filament needle which is inserted in a contracted painful knotted muscle to create a local twitch reflex which is both diagnostic and therapeutic as it is the first step in breaking the pain cycle as research shows will decrease muscle contraction, reduce chemical irritation, improve flexibility and decrease pain. When a needle is inserted into muscle it will also produce a controlled lesion and will cut between three to fifteen thousand individual muscle fibers. The body considers the needle as a foreign invader and will activate the immune system as a response. The cut muscle fibers also produce an inflammatory reaction that your body will respond to not just locally but all over the body to reduce inflammation systemically.

    Mechanical Effects

    • Dry Needling may mechanically disrupt a dysfunctional motor end plate.
    • Needling results in a Local Twitch Response (LTR)
    • The LTR results in an alteration to muscle fiber length as well as having an inhibitory effect on antagonistic muscles

      Neurophysiological Effects

      • Baldry (2001) suggests that dry needling techniques stimulate A-nerve fibers (group III) for as long as 72 hours post needling
      • Prolonged stimulation of the sensory afferent A-fibers may activate the enkephalinergic inhibitory dorsal horn interneurons, which implies that dry needling causes opioid mediated pain suppression
      • As Nunoz-Cortet et al. (2017) explains, following the technique there is a “liberating of endogenous opioid peptides, favoring tissue regeneration and reducing the concentration of nociceptive and sensitive chemical substances in the immediate environment around the trigger point.”
      • Another possible mechanism of dry needling is the activation of descending inhibitory systems which would block noxious stimulus into the dorsal horn
      • When you have a trigger point or a “knot” in a muscle, a chemical (acetylcholine) builds up around that area. Insertion of the needle into that muscle releases that chemical causing a small muscle contraction/LTR.

        Chemical Effects

        • Studies by Shah and colleagues (2001) demonstrated increased levels of various chemicals at sensitized motor end plates such as: Bradykinin, Substance P and CGRP (regulator of Calcium and Phosphate balance). These chemicals were reduced immediately post a LTR.
        • CGRP enhances the release of ACh from nerve terminals, which results in increased ACh receptors at the neuromuscular junction
        • Needle penetration will cause micro-trauma and micro bleeding (localized inflammation) and hence the introduction of platelet-derived growth factor into the area to help promote healing and tissue regeneration.