Pain of many types can lead patients to seek out addictive pain meds.
In my practice, I have found good success with the use of dry needling to relieve pain and improve function without all of the harmful effects of chronic opioid use.
This article is going to discuss the general differences between dry needling and acupuncture, common conditions that it can be useful for, how it works, and the risks and side effects associated with the intervention.
Dry needling vs acupuncture
Dry needling and acupuncture are both needle-based therapies and are quite similar, but they differ in their underlying principles, origins, and intended purposes. They are performed inserting very thin needles into muscles, tendons, and near other tissue like the bone and nerves.
These two treatments offer an adjunctive solution for a range of neuromusculoskeletal conditions.
Acupuncture, rooted in traditional Chinese medicine, has been practiced for thousands of years and is based on the concept of balancing the flow of energy, or "qi," through specific meridians in the body.
Acupuncturists insert thin needles into specific points along these meridians to restore the balance of energy and to address a wide range of conditions, including pain, stress, and various health imbalances.
On the other hand, dry needling is a more recent therapeutic technique grounded in Western medicine principles.
Instead of trying to alter the flow of qi throughout the body, it targets specific anatomical structures like muscles, tendons, and nerve pathways that can cause pain and restricted movement.
While acupuncture and dry needling both involve the insertion of the same type of needles I explain to my clients that instead of trying to alter the flow of energy in your body, I am trying to target the specific tissues that could be causing dysfunction. The techniques used all depend on the type of tissue and condition you are dealing with.
What conditions can dry needling treat?
Dry needling has shown efficacy in addressing a spectrum of neuromuscular conditions.
From chronic pain and muscle spasms to sports injuries, this technique is customized to target specific issues.
Here is a list of conditions that it can be useful for:
Jaw Pain
Nerve Pain
Tendinopathy
Osteoarthritis
Sports Injuries
Chronic Pain
Fibromyalgia
and more
For individuals struggling with chronic pain conditions, dry needling offers a non-pharmacological option to manage discomfort and improve quality of life. Athletes, too, find value in dry needling for its ability to address sports-related injuries and enhance recovery.
There are a few different techniques that can be performed, and each condition may call for a different technique. I’ll explain a few of the main techniques that I use.
What does dry needling do?
There are far more advanced ways to describe what is going on physiologically during a dry needling session, so if you’re looking for that please take a look at the resources below.
To make things a little bit easier to understand, I want to describe in more broad terms what happens to the body during and after a needling session.
Promotes muscle relaxation and increased blood flow
In order to contract and relax properly, our muscles need to have sufficient oxygenation via blood flow. Blood is constantly carrying oxygen to the muscles to replenish what we use.
When a muscle becomes hypertonic it is in a state of constant excitability and isn’t able to truly relax and replenish its oxygen stores, leading to muscle tightness, pain and dysfunction.
When we needle a hypertonic muscle, we aim to cause the muscle to twitch, either once or multiple times depending on the technique being used. After the muscle twitches, it will often relax to a more normal resting tone.
The act of the needle piercing through the tissue also creates micro damage in the tissues that will stimulate our natural inflammatory and healing response. This also helps in kickstarting the pain relieving response.
Provides pain relief from the spinal cord with endogenous opioids
Most people think of heavy pain meds when they hear opioids. The crazy thing is that our bodies actually create our own endogenous opioids in the spinal cord as well as other endorphins.
The secretion of these substances, combined with the increased flow of blood from the tissue damage, helps bring our self made pain-meds to the site of needle insertion which leads to an analgesic effect.
I often utilize electrical stimulation combined with the dry needles to promote a repetitive twitch response from anywhere between 15-30 minutes which further stimulates the exchange of blood and endorphins for further analgesic effect.
Alters myofascial tissues with unilateral winding and tenting
Picture yourself preparing a raw chicken thigh or breast. That white stringy stuff that you can pull off from it is called fascia, and our bodies have it as well.
Fascia might seem like a sort of “filler” in our bodies, but we are learning more and more each year how important of a role it plays in our movement and nervous system. It provides support to nearby tissues, helps reduce friction, and plays a supportive role for our organs. It can transmit tension created by muscle activity or external forces.
When our body is healthy, fascia is like a relaxed and wavy connective tissue. However, it can lose its flexibility if it's damaged by local injuries or inflammation. This can make fascial layers tighten, restricting the movement of underlying tissues, which can lead to pain, limited range of motion, or reduced blood flow.
Using the needle, we can perform unilateral winding where we twist the needle and wind it tight in one direction. What this does is wrap the fascia around the needle, stretching and pulling at it to alter the shape and structure of it.
Tenting is when we then pull on the tightly wound needle to continue to stretch the tissue even further. While it is not necessarily a pleasant feeling, it can be very useful for myofascial conditions!
Promotes improved joint and cartilage function
Several studies have found meaningful improvements in pain and disability for people with hip or knee osteoarthritis (OA) when a technique called periosteal needling was used.
Periosteal needling involves moving the needle close to the bone, joint line, or cartilage, or tapping the needle repeatedly onto the bone. When combined with an electrical current, it appears to stimulate cartilage repair in individuals with knee OA.
It was also found to enhance joint lubrication by affecting the hyaluronic acid in the synovial fluid. This suggests potential benefits for cartilage and joint health.
Now, I am not saying that it is going to regenerate all of your cartilage, but when combined with exercise and strengthening, we can help relieve a lot of the pain associated with chronic degenerative osteoarthritis to get people back to the functional things they want to be able to do.
What are the risks and benefits?
Like any medical intervention, dry needling comes with its own set of considerations. Potential risks include temporary soreness at the needling site, bruising, and a minimal risk of infection.
One of the more serious risks of dry needling that is important to take into consideration is pneumothorax or a collapsed lung, via puncturing the pleura.
The good news is, when performed properly by a trained professional, the likelihood of this occurring is very low.
While rare, It is important to highlight this risk so that clients can provide informed consent for their healthcare treatment.
In general, I say the benefits often outweigh the risks, with patients experiencing significant pain relief, improved range of motion, and accelerated recovery. The targeted nature of dry needling minimizes the risk of systemic side effects often associated with pharmacological interventions.
Conclusion
I don’t want you to leave here thinking that dry needling is some sort of “silver bullet” for all of your musculoskeletal conditions, but it really can be very useful for the relief of pain. It’s important to remember that it is better as an adjunctive treatment to a full physical therapy plan of care.
If you have any questions or are curious about how dry needling can benefit you and your condition, contact me to set up a phone consultation to determine appropriate treatment options for you!
**Disclaimer: The information provided in this article is intended for educational and entertainment purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider for personalized guidance and recommendations regarding your specific health concerns. The content presented here is based on general knowledge and research available up to the date of this article's publication. Any reliance on the information provided is at your own discretion and risk. The author and publisher do not assume any liability for any actions taken based on the information presented in this article.
References:
Butts, R., Dunning, J., & Serafino, C. (2021). Dry needling strategies for musculoskeletal conditions: Do the number of needles and needle retention time matter? A narrative literature review. Journal of bodywork and movement therapies, 26, 353–363. https://doi.org/10.1016/j.jbmt.2020.12.003
Dunning, J., Butts, R., Young, I., Mourad, F., Galante, V., Bliton, P., Tanner, M., & Fernández-de-Las-Peñas, C. (2018). Periosteal Electrical Dry Needling as an Adjunct to Exercise and Manual Therapy for Knee Osteoarthritis: A Multicenter Randomized Clinical Trial. The Clinical journal of pain, 34(12), 1149–1158. https://doi.org/10.1097/AJP.0000000000000634
Dunning, J., Butts, R., Zacharko, N., Fandry, K., Young, I., Wheeler, K., Day, J., & Fernández-de-Las-Peñas, C. (2021). Spinal manipulation and perineural electrical dry needling in patients with cervicogenic headache: a multicenter randomized clinical trial. The spine journal : official journal of the North American Spine Society, 21(2), 284–295. https://doi.org/10.1016/j.spinee.2020.10.008
Gatt A, Agarwal S, Zito PM. Anatomy, Fascia Layers. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526038/
Staehli Wiser, A., Dunning, J., Charlebois, C., Bliton, P., & Mourad, F. (2023). Periosteal Dry Needling for Carpometacarpal Osteoarthritis: A Prospective Case Series. Journal of clinical medicine, 12(17), 5678. https://doi.org/10.3390/jcm12175678
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