Dry needling is a minimally invasive technique involving the insertion of thin needles into specific trigger points in muscles or connective tissues to relieve pain and improve function.
Why it Matters:
Dry needling matters in pain management due to its ability to effectively target and alleviate musculoskeletal pain by directly addressing trigger points and promoting physiological responses that aid in pain relief and functional improvement.
In recent years, dry needling has emerged as a popular technique in the realm of pain management. This minimally invasive procedure involves the insertion of thin needles into specific trigger points in muscles or connective tissues without the injection of any substances, hence the term “dry.” This technique is distinct from acupuncture, although they both involve the use of thin needles. While acupuncture is based on traditional Chinese medicine principles and aims to balance the flow of energy (qi) along meridians, dry needling is grounded in Western medicine principles, focusing on targeting myofascial trigger points to relieve pain and improve function.
A dry needle is a thin, solid filament needle, typically made of stainless steel, that ranges from 0.16 to 0.30 millimeters in diameter and varies in length depending on the depth of the target tissue. These needles are similar to acupuncture needles but are used specifically for the purpose of dry needling therapy.
Dry needling is employed as a therapeutic intervention for various musculoskeletal and neuromuscular conditions. It is particularly effective for alleviating pain associated with myofascial trigger points, which are hyperirritable spots in skeletal muscle that are palpable as nodules or bands and often contribute to muscle pain and dysfunction.
The mechanism of action of dry needling involves several physiological processes. Firstly, the insertion of the needle into trigger points stimulates a localized twitch response, which is a reflexive contraction of the muscle fibers. This twitch response helps to release tension within the muscle and disrupt the cycle of pain. Additionally, the needle insertion promotes increased blood flow to the area, which can aid in tissue healing and repair. Furthermore, the release of endogenous opioids and other neurotransmitters at the site of needle insertion can contribute to pain relief by modulating the perception of pain signals.
Numerous clinical studies have investigated the efficacy of dry needling for various musculoskeletal conditions, yielding promising outcomes. A systematic review and meta-analysis published in the Journal of Orthopaedic & Sports Physical Therapy in 2020 analyzed 18 randomized controlled trials involving 1237 participants with musculoskeletal pain. The review concluded that dry needling was associated with significant improvements in pain intensity, disability, and global perceived effect compared to control interventions, such as sham needling or standard care.
Another study published in the Journal of Pain in 2008 [5] examined the effects of dry needling on patients with chronic low back pain. The randomized controlled trial compared dry needling to a sham needling group and found that the dry needling group experienced greater reductions in pain intensity and disability scores at both short-term and long-term follow-ups.
Moreover, a meta-analysis published in the Journal of Manual & Manipulative Therapy in 2019 evaluated the efficacy of dry needling for the treatment of myofascial trigger points in patients with neck pain. The analysis of 12 randomized controlled trials demonstrated that dry needling was associated with significant improvements in pain intensity, pressure pain threshold, and cervical range of motion compared to control interventions.
These studies collectively support the use of dry needling as an effective intervention for managing musculoskeletal pain and improving functional outcomes in patients with various conditions.
Dry needling is a valuable technique in the field of pain management, offering a targeted approach to relieving musculoskeletal pain and dysfunction. Through the precise insertion of thin needles into trigger points, dry needling can elicit physiological responses that promote pain relief, tissue healing, and improved function. Clinical studies have consistently demonstrated the efficacy of dry needling for a range of musculoskeletal conditions, further validating its role as a therapeutic intervention. As research in this area continues to evolve, dry needling is likely to remain a prominent component of comprehensive pain management strategies.
Written by: Joey Fio, Chief Programs Officer
[1] Dunning J, Butts R, Mourad F, et al. “Dry Needling: A Literature Review with Implications for Clinical Practice Guidelines.” Physical Therapy Reviews : PTR, U.S. National Library of Medicine, 19 Aug. 2014, pubmed.ncbi.nlm.nih.gov/25143704/.
[2] Cotchett MP, Landorf KB, Munteanu SE. “Effectiveness of Dry Needling and Injections of Myofascial Trigger Points Associated with Plantar Heel Pain: A Systematic Review.” Journal of foot and ankle research, September 1, 2010. https://pubmed.ncbi.nlm.nih.gov/20807448/.
[3] Gattie E, Cleland JA, Snodgrass S. “The Effectiveness of Trigger Point Dry Needling for Musculoskeletal Conditions by Physical Therapists: A Systematic Review and Meta-Analysis.” The Journal of orthopaedic and sports physical therapy, February 3, 2017. https://pubmed.ncbi.nlm.nih.gov/28158962/.
[4] Kietrys DM, Palombaro KM, Azzaretto E, et al. “Effectiveness of Dry Needling for Upper-Quarter Myofascial Pain: A Systematic Review and Meta-Analysis.” The Journal of orthopedic and sports physical therapy, September 4, 2013. https://pubmed.ncbi.nlm.nih.gov/23756457/.
[5] Tough EA, White AR, Cummings TM, et al. “Acupuncture and Dry Needling in the Management of Myofascial Trigger Point Pain: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.” European Journal of Pain (London, England), April 18, 2008. https://pubmed.ncbi.nlm.nih.gov/18395479/.
While we highly advocate for the utilization of dry needling as a valuable treatment option for pain management, it’s crucial to recognize that its effectiveness can be optimized when complemented with other interventions. Solely relying on dry needling may provide temporary relief; however, integrating it with additional treatments ensures a more comprehensive and long-lasting solution for pain management.