Could dry needling help you?

This blog was written by Sam Waagen, PT, DPT, OCS, Cert. DN.

Dry needling is the insertion of a thin monofilament needle within a variety of different sites within the neuromuscular system. Some examples include the belly of a muscle, within regions of peripheral nerves or neurovascular bundles, and teno-osseus insertion points. Dry needling differs from acupuncture in terms of both technique and rationale with the treatment. Dry needling does not follow Traditional Chinese Medicine principles with the desire to alter the flow of energy (“Qi”) along traditional Chinese meridians or treatment of diseases. Also, a dry needling treatment focuses on body regions that most closely affect the patient’s symptoms and sometimes at tender areas that are often referred to as “trigger points”.

The treatment of dry needling is multifaceted and affects the neuromuscular system on biomechanical, chemical, endocrinological, and vascular levels. Higher concentrations of inflammatory mediators, neuropeptides, catecholamines, and cytokines have been found in areas of chronic pain. Research has also measured greater acidity (pH), reduced blood flow (measured with US), compared to normal subjects. EMG studies have demonstrated increased electrical activity at “trigger point” sites and needling demonstrated a decrease in this hyperactivity.

As the needle makes contact with these sensitized nerve endings there is a cascade of events including the release of opioid peptides such as endorphins, enkaphalins, and serotonin. Functional MRI has shown positive effects at the limbic system, somatosensory cortex, hypothalamus, anterior cingulate cortex, and periaquaductual gray. Stimulating the needle also has the mechanical effect of stretching the connective tissue and triggering fibroblasts to release further opioid peptides.

Due to the multidimensional effect dry needling can have, it is used for a wide variety of conditions that may not resolve with traditional physical therapy treatments. Commonly, dry needling is thought of for myofascial pain conditions and the treatment of trigger points. However, this treatment can also be effective for many other chronic pain conditions, such as tendinopathies or radiculopathies. It can also be applied in conjunction with other effective treatment programs that require inhibition of hypertonic muscle groups, such as PRI.

For more questions related to dry needling, feel free to contact Samuel Waagen at 804-325-8822 or samuel_waagen@bshsi.org.