A healthy living blog from Marshfield Clinic Health System

Treating pain: Dry needling lives up to its name

graphic of dry needles with text

Dry needling uses needles similar to those used in acupuncture, but differs greatly in where they are applied.

When it comes to pain, you want as many options as possible to get you on the road to relief.

Now, an option with a weird name may be just the thing to help you manage pain – dry needling.

Marshfield Clinic physical therapists have added dry needling to their treatments for acute or chronic pain.

It’s like a tool that’s part of our physical therapy toolbox,” said Heather Nelson, a physical therapist who has been trained in the technique. “It’s an alternative to doing trigger point release massage or deep tissue massage.”

And unlike pain medication injections, it doesn’t involve injecting medicine or other liquids into the body. Hence the name, dry needling.

Nelson said introducing a needle into a trigger point or tight spot in a muscle causes an involuntary twitch reflex. In the process, it fatigues that section of muscle, which makes tighter spots relax and pain subside. Another way to look at it is to consider a muscle being stuck in the “on” position; the needling twitch triggers a “re-set” to allow the muscle to relax and work normally.

Dry needling works from the inside out

“It’s a more direct way to get muscles to loosen up, like we’re doing it from the inside out. We find it lasts longer than massage therapy in certain situations,” Nelson said. Dry needling has the same needles as acupuncture but uses a completely different philosophy.

In general, dry needling treats trigger points based on a provider feeling them by hand, along with muscle pain patterns, as opposed to pre-determined points in the body that is typical with acupuncture. Rooted in ancient Chinese philosophy, acupuncture needling insertion is more specific to certain pathways within the body to re-balance energy flow. Physical therapists, by contrast, determine dry needling treatment areas based on palpable muscle tightness and trigger points that may cause radiating pain.

Who can benefit?

Dry needling can be an effective adjunct for treating cases of tennis elbow, sciatica, calf tightness, headaches and neck and low back pain. It’s not a cure-all, however.

Among other precautions, this technique is not appropriate for certain kinds of pain locations, people with needle phobia or women in their first trimester of pregnancy. Your physical therapist will discuss this with you prior to treatment.

“People who have heard about the technique will say they just want to be needled, but it doesn’t work that way,” she said. “We might do this to help decrease tension in a muscle, but we want to figure out why the tension is there in the first place to prevent it from coming back.”

Uncomfortable but tolerable

Worried about needles? Nelson said when the needle is inserted and hits a trigger point, it’s uncomfortable but tolerable, similar to a cramp. Discomfort mostly disappears when the needle is withdrawn after 30 seconds. Dry needling is typically performed once a week for a particular muscle group and may be used for one to four visits.

Physical therapists at Marshfield Clinic are trained in dry-needling technique. They are not licensed acupuncturists and do not practice acupuncture.

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