Dry Needling, or Intramuscular Manual Therapy, is a neurophysiological evidence-based treatment technique used to treat myofascial pain that uses a dry needle, without medication. When inserted into a contracture knot, the goal is to release or inactivate the trigger points and relieve the pain. A sterile, solid, filiform needle is inserted into specifically selected point on the body.
Dry Needling vs. Wet Needling
• Dry needling uses a solid fine needle.
• Wet needle uses a thick hollow-bore hypodermic syringe to intentionally introduce a fluid substance for therapeutic effect. (ie. trigger point injections)
Dry Needling vs. Acupuncture
• Clinical or medical dry needling should be distinguished from acupuncture.
• Tools used are similar; both procedures use a solid, stainless steel, sterile, disposable filiform needle.
• Difference distinguished by diagnostic criteria, therapeutic intent, methodology, treatment planning and documentation different.
• Acupuncture relies on ancient eastern philosophies such as: Meridian channels, relationships between proposed functions of organs, determination of status of unseen energetic flow and other criteria to assess the condition of the patient and plan treatment.
o Utilizes Chi, invisible energy meridians, functional organ association, tongue diagnosis, pulse diagnosis, among others.
• Dry Needling/Intramuscular stimulation relies on contemporary western clinical diagnosis and assessment principles. The points are chosen for neurological and physiological significance based on myofascial and neurological disorders.
o Intent: Improve function, reduce pain, painful trigger points, and adhesions, creates a biochemical response to help a chronic injury heal faster.
Frequently Asked Questions:
• How does dry needling work? There are mechanical and biochemical effects. Based on the pioneering studies by Dr. Jay Shah and colleagues at the National Institutes of Health, we know that inserting a needle into trigger points can cause favorable biochemical changes, which assist in reducing pain. It is essential to elicit so-called local twitch responses, which are spinal cord reflexes. Getting local twitch responses with dry needling is the first step in breaking the pain cycle.
• What type of problems can be treated with dry needling? Dry needling can be used for a variety of musculoskeletal problems. Muscles are thought to be a primary contributing factor to the symptoms. Such conditions include, but are not limited to neck, back and shoulder pain, arm pain (tennis elbow, carpal tunnel, golfer’s elbow), headache to include migraines and tension-type headaches, jaw pain, buttock pain and leg pain (sciatica, hamstrings strains, calf tightness/spasms). The treatment of muscles can have a great effect on reducing pain mechanisms in the nervous system.
• Is the procedure painful? Most patients do not feel the insertion of the needle. The local twitch response elicits a very brief (less than a second) painful response. Some patients describe this as a little electrical shock; others feel it more like a cramping sensation. Again, the therapeutic response occurs with the elicitation of local twitch responses and that is a good and desirable reaction.
• Are the needles sterile? Yes, we only use sterile disposable needles.
• What side effects can I expect after the treatment? Patients may report being sore after the procedure. The soreness is described as muscle soreness over the area treated and into the areas of referred symptoms. Typically, the soreness lasts a few hours.
• What should I do after having the procedure done? Our recommendations vary depending on the amount of soreness you have and on the individual response to the treatment. Recommendations may include applying heat or ice over the area, gentle stretches and modifications of activities. It will not preclude you from doing your daily activities.
• How long does it take for the procedure to work? Typically, it takes from one to a few visits for a positive reaction to take place. Again, we are trying to cause mechanical and biochemical changes without any pharmacological means. Therefore, we are looking for a cumulative response to achieve a certain threshold after which the pain cycle is disturbed.
• Where does dry needling fit in the entire rehabilitation program? Generally speaking, dry needling is a modality when it comes to treating patients in the clinic with the presence of trigger points. More frequently, dry needling is needed in the beginning in order to break the pain cycle. Once that is achieved, other treatment options are introduced.
• Once I am feeling better, how often do I need to come back to maintain my progress? The musculoskeletal system is under constant pressure from gravity, stress, work etc. A regular exercise program combined with good posture can prevent many problems. If the pain comes back, “tune-ups” are recommended to treat and prevent serious injuries.
If you think dry needling would be a good treatment option for you, contact our office at 865.691.3155. Our chiropractors are trained in dry needling and would love to help you identify and eliminate your pain without medication.