WHAT IS DRY NEEDLING?
Dry needling is a skilled intervention that creates a systemic response for the management of chronic and acute neuromusculoskeletal pain and movement impairments. Dry needling utilizes sterile, single-use, thin filiform needles to penetrate the dermis. The effect is to stimulate underlying myofascial trigger points and connective tissues. We are enthusiastic that beginning in 2019 licensed Idaho physical therapists with at least one year of practice experience may perform dry needling upon successful completion of training.
Recently, the state of Idaho formally recognized the value of this powerful physical therapy treatment to address dysfunctions in local skeletal muscle, fascia, or connective tissue. The mechanical, local stimulation of dry needling creates an environment that aids the body’s ability to heal and reduce pain endogenously.
The physiological effects of dry needling treatment depend on the tissue targeted and treatment objectives. For example, trigger points (TrPs) are hyperirritable spots within a taut band of contractured skeletal muscle fibers that produce local and/or referred pain when stimulated. These “spots” are not just tight bands of muscle, as research has demonstrated that TrPs also have altered cellular activity characterized by hypoxia and ischemia (inadequate supply of oxygen at the tissue level). It has been shown that dry needling inactivates myofascial TrPs by eliciting a trigger response (an involuntary contraction of the taut band) through the nervous system.
This trigger response has also been shown to decrease the concentration of inflammatory chemicals within the TrP, normalize local blood circulation, and decrease TrP irritability locally and more remotely. Whereas our nervous system is the hard wiring of how our body functions, benefits of dry needling are not just seen locally at the site of the treatment, but also at more distal locations.
CELL PROLIFERATION THROUGH DRY NEEDLING
Additionally, dry needling treatment is effective in remodeling scar tissue, especially in relation to the effects it has on fibroblastic activity. When dry needling is used in combination with manual rotation of the needle, it places fibroblasts in a high tension matrix, at which point the fibroblast changes shape and assumes a lamellar shape, and increases its collagen synthesis and cell proliferation. There is strong evidence that dry needling directly activates fibroblasts through mechanical manipulation of the needle, which in turn activates the release of cytokines and other pro-inflammatory mediators. Dry needling plays a substantial role in a process called mechanotransduction, where the body converts mechanical load into cellular responses.
DRY NEEDLING IS MORE POTENT WHEN USED WITH OTHER EFFECTIVE INTERVENTIONS
Dry needling is rarely effective as a stand-alone treatment and is best utilized as a part of a broad
intervention in the process of restoring normal tissue and body function. Dry needling ideally may be incorporated into a physical therapy treatment plan when myofascial TrPs are identified. These TrPs can lead to impairments in body structure, pain, range of motion, and functional limitations. Thus, the cumulative effect of physical therapy interventions paired with dry needling can be remarkable and long-lasting.
CONDITIONS DRY NEEDLING IS VALUABLE AT TREATING
Dry needling is often effective in the treatment of numerous diagnoses such as:
• Lumbar/Thoracic/Cervical Pain
• Chronic / Acute Pain
• Joint Pain
• Craniomandibular Dysfunction/TMD
• Carpal Tunnel Syndrome
• Nocturnal cramps / Hypertonicities
The physical therapists at Wright Physical Therapy evaluate the function of your neuromuscular system to determine what tissues contribute to your painful limitation(s). They apply dry needling techniques in conjunction with other effective treatments to improve healing, decrease pain and increase overall function. Call your nearest Wright Physical Therapy clinic location to see how dry needling can help you get to the root of your pain. WrightPT.com has updated locations and contact information as well as education on subjects related to orthopedic care and sports medicine.
Watch our 3 part series below and learn more about dry needling from our doctor of physical therapy, Xavier Beckham.