Dry needling is literally dry, does not include any fluids unlike a vaccine needle.
Also, this is sterile, single-use like an acupuncture needle that penetrate the skin, muscle and other connective tissue, used in order to decrease the pain, improve ROM (Range of Motion) and deactivate the MTrPs (myofascial trigger points) that causes muscle pain and referral pain.
Distinction between acupuncture and dry needling
Different Concept
Acupuncture: Needle points are based on a meridian which is energy pathway in Chinese medicine. The philosophy of Chinese medicine is that people get sick or start having some pain when this pathway is blocked or stopped. Depth of the needling the practitioner put in body can be different and shallower since they do not aim for muscle. To maintain and restore body balance and energy flow called (Qi), acupuncture needle is used.
Dry needling: Put needle in the MTrPs which is quite similar (approximately 70%) to meridian but not exactly same. MTrPs is that some of the muscle fibres get shortened or elicit taut band in the muscle. MTrPs can provoke weakness of the muscle, reduction of the ROM, and pain referral to different location. When the needle goes into the muscle, twitch response can happen which is quick muscle contraction and relaxation is good body reaction to release MTrPs.
How does dry needling work? *1,2
Dry needling not only releases MTrPs but also activates immune system as needle makes micro muscle tear in the muscle fibre which helps end fresh oxygen, nutrient and blood to the area. When we needle the muscle, you often get a local twitch response which gives neural impulse to MTrPs circuit. This stimulation by needles helps manage the pain (Gate control theory).
When to use dry needling?
- When hands on does not help conditions or as a different modality
- People cannot tolerate massage for some reasons such as tight myofascial or sensitive pressure
- To release MTrPs
- When need to work on deep muscles such as gluteus minimus, piriformis and vastus intermedius.
*Make sure not to needle when the patients are sick or low in energy.
What you may feel and side effect of dry needling
- Heaviness and dull are good signs
- Muscle twitch
- Sweating, sharp, numbness, fast-heart rate and faint need to be monitored
- Bruising and bleeding- when the needle hits the small capillary
*Heaviness in the muscle can last a few days up to 1 week as body needs to recover and work on to fix muscle fibres.
Contraindication
- Needle fobia (Fear or scared of having needle)
- Low in energy or sick
- Pregnancy
- Diabetes
- Pacemaker
- Bleeding disorders
- Epilepsy
- Allergic to metals
- Cancer
- On anticoagulants medication
- Acute immune disorders (acute rheumatoid arthritis and systematic lupus erythema)
- Frail patients
- Kidney condition
- Skin injury or wounds
Endangerment site
- Popliteal fossa
- Cubital fossa
- Inguinal area
- Carotid artery
- Radial artery
- Lung
- Heart
- Other organs
*When Pneumothorax (lung puncture) happens,
- It won’t be noticed on the same day, takes 2 days to appear the symptoms
- Know the signs and symptoms such as chest pain, cough and short breath
- Ask the symptoms (Practitioner)
- Send the person to the hospital to take chest X-ray
- Call to the hospital to explain what happened
- Record when, what happened and who spoke to
- Inform the insurance company
Safety Guideline
- Bent needle: if realised before using the needles, do not use.
- Broken needle: make sure where proper cloths and shoes
- Stuck needle in the body: Use a tweezers to take it off
If this does not work, put a circle on the skin where the needle is and send the person to the hospital
Needling is safe
Myotherapist is trained at least a year to needle since it is a part of the course. It can cause a fainting or nausea if the patients are too scared or first time to have needling due to body response.
It is really crucial for practitioner to know the anatomy, side effect and contraindication to needle.
Advise not to exercise or do intense work out on the day you received needling session as the body needs to recover and needling activate immune system.
References
- James Dunning, Raymond Butts and Thomas Perreault Dry needling: a literature review with implications for clinical practice guidelines Physical Therapy Reviews 2014 19 (4): 252-265
- Lewit K. The needle effect in the relief of myofascial pain. Pain. 1979;6(1):83–90
- Physical therapists & the performance of dry needling: an educational resource paper. Alexandria, VA, USA: APTA Department of Practice and APTA State Government Affairs; 2012.
- Melzack R, Stillwell DM, Fox EJ. Trigger points and acupuncture points for pain: correlations and implications. Pain. 1977;3(1):3–23.
