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What Is Dry Needling?

Examining the Health Trend & Its Benefits
 Jun 19, 2018  15 min read

Dry needling – also know as Intramuscular Manual Therapy (IMT) – is growing more and more popular in the US as more physical therapists become certified in it. But what is dry needling? And does it live up to the hype? We’ll answer these and more questions below.


What are myofascial trigger points?

The main purpose of dry needling in physical therapy is to treat pain and dysfunction by releasing myofascial trigger points. Myo-what points? Let’s break these terms down first:

Myo is the Latin (or fancy scientific) term for muscle.

Fascia is a type of connecting tissue. This web-like tissue covers and weaves through many internal organs, including your muscles. “Myo” and “fascial” together mean muscle connecting tissue, or the fascia that wraps in and around your muscles.

So now that you get the gist of what “myofascial” means, what are these so-called trigger points? Officially, myofascial trigger points are “hyperirritable spots in skeletal muscle that are associated with hypersensitive palpable nodules in taut bands.” In laymen’s terms, a trigger point is a painfully tight area in your muscle. Unlike when a whole muscle cramps though, only a single band of muscle fibers are taut. You may have heard someone describe having a “knot” in their muscle, which was likely a trigger point. We don’t yet know the exact cause of myofascial trigger points, but we know they can cause a lot of pain and dysfunction if left untreated.



How do I know if my pain is from a trigger point?

Myofascial trigger points can feel like knots in the muscle. The point will be tender or painful to touch in one spot, rather than the entire muscle. Other symptoms include weakness or lack of flexibility in the affected muscle. Trigger points can also “refer” pain to other parts of the body, causing headaches, toothaches, back pain, and other issues, making them difficult to diagnose if you don’t know what you’re looking for.

Researchers have been able to view myofascial trigger points through specialized ultrasound and MRI techniques. However, these techniques are not widely available or affordable, and you don’t need a lot of fancy imaging to find out if your pain is caused by trigger points. A qualified practitioner can palpate or touch the muscle to feel for taut bands or look for a “twitch response” to confirm that the painful spot is a trigger point.

Sometimes, the best way to determine whether or not you have trigger points is to treat them! A myofascial pain treatment like dry needling will help you determine if trigger points are the main source of your pain while simultaneously treating it.



How does dry needling work? Walk me through the steps.

Even if you aren’t afraid of needles, you might feel a little nervous about the idea of a needling treatment, so let’s walk through the process together.

Finding the problem point is our first order of business. Your PT will use one to two fingers to press into different areas of your muscle, feeling for tight areas or “knots” in the muscle and gauging your reaction. This palpating shouldn’t hurt until they press a trigger point. If gentle but firm pressure on the spot makes you go, “Ouch! That hurts!” – it’s probably a trigger point.

Another way to find a trigger point is to look for a twitch response. Your PT will rub over the suspected trigger point, which will cause the muscle to flex involuntarily. This “twitch” confirms the existence of a myofascial trigger point in the muscle.

Next, the PT inserts needles through the skin and into the muscle layer, targeting the trigger point. Having uncomfortable flashbacks to your last flu shot? Try not to worry – the needles doctors use to inject medicine into the bloodstream are usually hollow hypodermic needles, while most dry needling practitioners will opt for solid filiform needles instead. They’re “dry” because no medicine is being injected, and since they’re solid, they’re usually much thinner than the hollow needles you experience at the doctor’s office.

Once the needle is inserted, there are different methods that the physical therapist can then apply to help release the trigger point: moving the needle in and out or rotating the needle (dynamic), or leaving the needle in (static) for a few minutes. Some therapists may also add IES – intramuscular electrical stimulation – at low voltage to the still needles, which can help to further relax the muscle and improve circulation.



Is dry needling painful?

We know what you’re probably wondering – will this hurt? As we’ve said, the insertion of the needle itself shouldn’t cause significant pain. However, you’ll probably feel it when the trigger point is released. The nerves around the trigger point are already sensitized, and as the “knot” releases, blood rushes to the area that was previously cut off from the blood supply. This can cause sensations ranging from a tingle to sharp pain, depending on your tolerance and the location of the trigger point. Your PT will work with you to gauge your pain levels and make sure the treatment isn’t more than you can handle. They may also recommend other modalities (like ice, heat, or stretching) to help with soreness and continue the healing process afterwards.

In general, any pain you experience from dry needling will be much less than the pain of having trigger points in the first place!



Is dry needling safe? What are the risks?

Dry needling is a relatively safe medical treatment. Getting dry needling done has less risk than taking over-the-counter aspirin or ibuprofen. Since dry needling does break the skin, a practitioner will follow the standard safety guidelines: ie, clean equipment, disposable one-use needles, and regularly washing hands. Your physical therapist also has years of training and expertise regarding human anatomy, so while dry needling is a safe practice in the hands of a certified expert, don’t try this at home!

The primary side effects of dry needling are soreness in the area of treatment and occasional bleeding. There are some instances in which a patient should not receive dry needling, or may want to discuss with their physician and physical therapist about whether or not dry needling is safe for them. For instance, if you have lymphedema, thrombocytopenia, a compromised immune system, vascular disease, or are on anticoagulant or blood-thinning medication, it is not recommended that you receive dry needling.


Who can benefit from dry needling? What does it treat?

The short answer: dry needling works on trigger points to relieve pain.

The long answer: dry needling works on EVERYTHING. It’s not because dry needling is the magical answer to all maladies, but because trigger points can affect more parts of the body than you’d think. Headaches, toothaches, sciatica, a sore throat, fibromyalgia symptoms, and chest pain can all be caused by muscular trigger points. And where trigger points are the problem, dry needling provides an affordable solution.

Of course, dry needling doesn’t have to be (and shouldn’t be) the first thing you try for all kinds of pain. If you experience chest pain, for instance, you should go to the hospital first, and then your physical therapist. But it’s good to keep in mind that many instances of pain and physical dysfunction have a simple solution — once you’ve ruled out more serious causes.


Do all physical therapists offer dry needling/ IMT?

Intramuscular Manual Therapy, or dry needling, is a specialization, so it’s not taught in general physical therapy education programs. Providers must go through a separate, intensive training program to receive dry needling certification. Many Physical Therapists in the US are now getting this certification, as more see the benefits of a service that is both accessible and effective. However, only about 2/3 of American physical therapists currently offer dry needling.

All Compleat Rehab & Sports Therapy clinics have providers that offer dry needling, so you can access this service at any of our clinics. (Find a location here.)


Is it covered by health insurance?

Dry needling isn’t usually covered by health insurances as a separate service. However, most will cover general Physical Therapy services, and a certified PT can include dry needling as a part of your overall treatment. Plus, some studies indicate that dry needling is most effective when accompanied by stretching, corrective exercise, and manual therapy. Having a well-rounded treatment approach means better results for you!


How much does dry needling cost?

At Compleat Rehab, a single dry needing session costs $35. However, if you’re already getting physical therapy with us, we’re happy to include dry needling in your overall physical therapy plan at no extra cost.


Why should I try dry needling?

Trigger point dry needling treats just that – trigger points. So why choose dry needling for any old pain symptoms? The truth is, the most common causes of pain are often musculoskeletal, and trigger points may be the likely culprits. In fact, myofascial pain may account for up to 85% of pain complaints at primary care clinics.

While dry needling isn’t a magical cure-all for what ails you, it is a proven, effective method to treat trigger points and the pain they cause. If there was one simple, common reason for your pain and a low-cost, low-risk treatment for it, wouldn’t you try it?


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This notice was published and becomes effective on August l, 2011.