What is Dry Needling?

Dry Needling (DN) Frequently Asked Questions

Q: What is dry needling used for?

A: Dry needling is a clinical technique used to evaluate, then treat dysfunctional tissues in the body associated with orthopedic and neuromuscular problems. Areas that are often treated aren’t just limited to muscles but may include tendons, ligaments, scars and even bone surfaces. That depends on the diagnosis and the clinician’s findings. 

Q: Is dry needling like acupuncture?                     

A: It IS like acupuncture in the sense that acupuncture needles are used.  The reason they are used is because unlike hypodermic needles they are not hollow (to allow fluid to be injected) and are typically much smaller.  This GREATLY lessens the chances of infection as well as minimizes discomfort.

But Dry Needling is NOT acupuncture. Acupuncture attempts to balance energy meridians by inserting the needles into a mapped set of acupuncture points. Dry needling involves examining regions under the skin after first examining the patient with standard physical medicine techniques. After this exam, the clinician uses the needles to locate precisely what depth and angle the abnormality is and can then pierce it with the tiny needles. Your clinician is looking for a “block” that is preventing normal healing and needling it. A complicated process known as REMODELING follows that the body uses to heal itself.

Q: Does dry needling hurt?

A: Believe it or not, NORMAL MUSCLE DOES NOT HURT WHEN A NEEDLE GLIDES THROUGH IT! But as we’ve said before, we’re “looking” for abnormal places with the needle.  These absolutely can be, and usually are, tender.  It is described by most recipients as a dull ache like a toothache and is well tolerated by most people. Exceptionally fine needles are used, and they are inserted with a small tube that masks the sharp stab of the needle entry that is expected by most patients.

Q: What are the effects of dry needling?

A: The answer to that is complicated.  There is a chain reaction that begins the second the needle is inserted. Chemicals are released in response to the needle. Nerve impulses are stimulated that travel to the spine first, then to the brain. The brain in turn releases its own chemicals and it sends nerve impulses back down the spine as well.  You may feel some of these nerve and biochemical reactions and you may not. You can see the way it can affect other areas of the body because of the messages traveling through the circulation as well as in the spinal cord and brain.  But the simple answer is this. EVERYTHING YOUR BODY NORMALLY DOES TO HEAL IS ENHANCED BY DRY NEEDLING. DRY NEEDLING UNBLOCKS AND SPEEDS UP THE WHOLE PROCESS.

Q: What does dry needling feel like?

A: Around each needle there is usually a dull ache that usually diminishes rather quickly. Often patients feel relaxation and warmth in the surrounding tissue or even in other parts of their body. This might happen quickly and sometimes it takes some time over a few treatments.

Q: Why are there different sized needles?

A: We try to make Dry Needling as comfortable as possible; however, sometimes the tissue that needs treatment is NOT close to the surface. So different sized needles are needed to reach all the way to the part that needs the help.

 Q: Can it cause headaches or migraines?

 A: President John F. Kennedy’s doctor is credited in many circles for discovering that precisely piercing tissue releases a muscle knot that may have been present for a long time–even for years.  Sometimes, this can trigger the very symptom we’re trying to relieve! But your clinician knows this and will discuss it with you.  It does NOT mean it will happen every time or you will react to DN that way every single time.  WHAT IT DOES MEAN IS WE’VE FOUND A KEY THAT NEEDS TREATMENT. It may end up that DN is the exact treatment you need. We often find that DN can actually abort a migraine or other headache.

Q: When is it appropriate and how often would one needle for maintenance of chronic conditions?

A: Sadly, some diseases simply don’t have a cure. Diabetes is an example. It must be MANAGED with insulin. Arthritis is another example. It must be managed.  DN may be used to help manage the pain and the loss of function with many such conditions. DN will also improve the quality of life in many conditions that are not curable. The frequency of treatments will depend on your response to DN, since different people respond differently to different medical interventions.

Q: What does DN do?

A: It finds and treats areas blocking the normal healing, then it speeds the process of healing. If a condition can’t be fully healed, DN helps you to manage its consequences.

Q: How long does it last?

 A: Some people fully recover after 1-3 treatments. Others take longer. There are even a few that simply don’t respond to DN.  You and your clinician will discover this together.

Q: How often should I get it done?

A: Twice a week at first while we’re seeing how your body responds. 

Q: Why do you leave them in longer sometimes and remove them quicker others?

 A: There are multiple techniques within the field of DN. There are many different methods that may be used by your HCP. Which technique is used for each case is different depending on your clinician’s training as well as the examination findings of your case.

 Q: When and why do you use electrical stimulation?

 A: Electrical Dry Needling (EDN) involves attaching wires from a small TENS-type unit to specific needles. Your clinician can set the unit to enhance the release of certain chemicals in the body. Some of these help pain, some promote healing, and some do both. While the stimulation is comfortable for most, some patients just don’t care for it. We will work with you to discover what your body responds to the best.

Q: When can I exercise after treatment?

A: Your HCP will give you specific direction on this, depending on your body’s response to the goals of treatment.

Q: Should I use ice or take anti-inflammatories?

A: Most have the idea that inflammation is a bad thing.  The truth is that the body uses inflammation to heal. What is counterproductive is chronic inflammation. The fascinating thing that research has discovered is the body responds to the tiny micro-traumas of each needle stick with a small, acute, healing inflammatory response. The body then uses this response to a “controlled injury” to stop the chronic inflammation and repair itself. This is much like what happens when an orthopedist elects to perform a microfracture surgery.  Repair is stimulated by a “controlled injury” in the hands of an expert clinician. So now you can see how ice and anti-inflammatory medicines will blunt the healing process initiated by DN, since DN seeks to use new inflammation to take out the old. Therefore, we recommend heat and pain medicines if needed, rather than ice and anti-inflammatories.

 Q: Is it safe for people on blood thinners?

A: In most cases DN can still be used if you are on anticoagulant medicines since these needles are so tiny; however, your HCP will take special precautions and techniques. You may notice more bruising after treatment than someone else does. Your HCP will discuss this with you.

Q: Is there risk of infection?

A: There is a risk of infection anytime the skin is penetrated. That is why the use of needles is restricted to certain professionals within medicine. FORTUNATELY, the risk of infection is EXTREMELY small. Not only are sterile needles inserted after proper cleaning they are disposed of immediately afterwards and NEVER autoclaved or sterilized and re-used. As previously stated, the needles are not hollow, which also minimizes the risk of infection. A hypodermic needle carries a tiny piece or plug of skin with it during the puncture, so if there are any germs that survived the skin cleaning procedure they are introduced into the body. There is no skin plug since acupuncture needles aren’t hollow.