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Trey Larant

Dry Needling FAQ's


Dry needles being administered to a patient's upper back.


What is dry needling?

Dry needling is a skilled intervention that uses a thin filiform needle to penetrate skin and stimulate underlying neural, muscular, and connective tissues for the evaluation and management of neuromusculoskeletal pain and movement impairments.


How is this different from acupuncture?

Although both dry needling and acupuncture use the same needles, acupuncture is based on traditional Chinese medicine. The goal is to adjust the flow of energy (qi) throughout the body along Meridian lines, balancing Yin and Yang. Acupuncture can treat everything from nausea and vomiting to internal organ issues, whereas dry needling is used to treat neuromusculoskeletal disorders based on Western medicine. (It is important to note that many acupuncturists treat using both traditional Chinese and Western medicine, and the inclusion of dry needling by physical therapists is not meant to replace or diminish the skills acupuncturists have to offer).


What are the benefits of dry needling?

  • Pain reduction and decreased use of pain medication

  • Decreased muscle tension

  • Improved circulation/blood flow

  • Promotes tissue healing

  • Remodels scar tissue

  • Anti-inflammatory

  • Faster return to activities

  • Reduction in disability


What conditions can dry needling treat?

  • Acute and chronic pain

  • Osteoarthritis

  • Tendinopathies

  • Carpal tunnel syndrome

  • Temporomandibular (TMJ) disorder

  • Spasticity after strokes

  • Piriformis syndrome/sciatica

  • Plantar fasciitis

  • Migraines

  • Tension headaches

  • Calcific tendonitis/frozen shoulder


Does it hurt?

The size of the needles used are usually between .25 and .30 mm in diameter, or for reference an average of 10 dry needles can fit inside of a common needle for vaccine administration. Some individuals feel a small prick when the needle is inserted, others don’t feel the needle entering at all. When it is inserted into your area of pain/injury, you usually feel a deep ache. After treatment, some individuals feel some mild soreness for the next few hours.


How long does the treatment last?

Current research shows the best effect of dry needles is when they are left in place for 10-30 minutes. It also shows better results with the use of electroacupuncture, in which a small electrical current (similar to TENS) is put through the needles, and/or with needle manipulation including bidirectional or unidirectional rotation of the needles. We are able to start with shorter time frames and/or without the use of the electrical stimulation for those who are new/nervous with needling. Also, to note we will not use the electrical stimulation on anyone with a history of seizures or with an implanted pacemaker/defibrillator.


How many times will I have to be needled to see results?

Our goal is to get a sizable response 24 hours after the first treatment. For those with new injuries the aim is a 50% improvement in symptoms but can be less for those with more chronic conditions. Most injuries are treated anywhere between 1 and 10 times, with an average of 6 times. Dry needling has a cumulative effect, meaning if you had 50% improvement in symptoms after your first session, we would be aiming for an additional 10-20% your second session, another 5-10% your third, etc.


How often should I get needled?

Most patients start one to two times per week, and then decrease the frequency after that. For example, a common schedule might be two times the first week, once the second, then once in two weeks, a month later, and a few months after that. However, it is really patient/symptom specific as everyone’s injuries are different.


Are there risks?

There are risks to dry needling as most medical procedures, however it is generally a very safe and effective therapy tool. For starters, only physical therapists and other select medical providers with years of training in the neuromusculoskeletal system are able to administer the treatment. Along with this, physical therapists in Washington state must take 75 hours of in-person continuing education classes on dry needling to become certified. The biggest risk with dry needling is a pneumothorax or collapsed lung. This is why we are extremely careful and diligent with placing needles around the thoracic region to ensure we are not needling into a lung field. We are also instructed to use bony backdrops and/or your own fingers to make sure the needle tip is exactly where we want it. Other risks include nerve injury and infection. However, these risks are very rare with dry needling, with an occurrence of less than 0.1%.


What are some common side effects?

  1. Pain/soreness

  2. Feeling relaxed/sleepy or energized

  3. Sweating

  4. Nausea

  5. Feeling faint/dizzy

  6. Bruising

  7. Light bleeding


If you are interested in learning more about dry needling or trying it out for yourself, schedule a physical therapy appointment with us! (Please note: Although the dry needling bill has already been passed by the legislature for Washington state, the bill will go into full effect until approximately January 2024. Washington is currently the LAST of 46 states to legalize dry needling for physical therapists. After which, only New York, Oregon, California, and Hawaii remain without legalized dry needling.)



References

1. Dunning J, Butts R, Mourad F, Young I, Flannagan S, Perreault T. Dry needling: a literature review with implications for clinical practice guidelines. Physical Therapy Reviews. 2014;19(4):252-265. doi:https://doi.org/10.1179/108331913x13844245102034


11. Butts R, Dunning J. Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals. International Journal of Physical Medicine & Rehabilitation. 2016;04(02). doi:https://doi.org/10.4172/2329-9096.1000327


111. Dunning J, Butts R, Young I, et al. Periosteal Electrical Dry Needling as an Adjunct to Exercise and Manual Therapy for Knee Osteoarthritis. The Clinical Journal of Pain. Published online May 2018:1. doi:https://doi.org/10.1097/ajp.0000000000000634


1v. Boyce D, Wempe H, Campbell C, et al. ADVERSE EVENTS ASSOCIATED WITH THERAPEUTIC DRY NEEDLING. International Journal of Sports Physical Therapy. 2020;15(1):103-113. doi:https://doi.org/10.26603/ijspt20200103


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