What is dry needling?
Dry needling uses a fine monofilament, sterile needle to treat tender muscles (trigger points), neuro-muscular pain, or movement dysfunctions. The therapy is NOT acupuncture and is based completely on a Western medical model. Dry needling requires thorough examination and diagnosis by your physical therapist in order and treats dysfunctions specific to you as an individual
How does this therapy help me?
The benefits can include
- decrease in muscle tightness,
- pain, or
- dysfunction due to chronic or acute musculoskeletal conditions.
Does dry needling hurt?
Dry needling uses very thin needles which, typically, are not painful. Occasionally, a patient feels a small pinprick. Because the needles do not contain medication, we use very thin needles that are 8x smaller than those used for your vaccines. While some areas may be more tender than others, dry needling typically does not cause more pain than your current symptoms.
How long does a session last? In general, how many treatments will I need?
A typical dry needling session usually lasts 10-15 minutes. Additionally, when indicated, your therapist may utilize electrical intramuscular stimulation to elicit twitch responses in multiple muscles in order to decrease pain. In acute pain situations, only one session may be needed. For more chronic pain situations, it may take several treatments to notice a change. Because dry needling can have a cumulative effect, if you do not notice results after the first session, we typically recommend 2-3 treatments before deciding to pursue other options.
What should I do after a treatment?
After a treatment, you may do the following based on your comfort level. Please note that if it hurts or exacerbates your symptoms, then discontinuing the activity is best.
- Work out and/or stretch
- Participate in normal physical activity
- Massage the area
- Use heat or ice as preferred for post treatment soreness
- If you have prescription medications, continue to take them as prescribed
What should I not do after the needling therapy?
- Unfamiliar physical activities or sports
- Doing more than you normally do
- Excessive alcohol intake
How deep do needles go?
Typically 0.5 inches to 4 inches, the needles used depend on the muscle tissue being treated. For example, the therapist can use a 1 inch needle to treat the upper trapezius when a 4 inch needle gets used to access deeper muscles such as the piriformis in the hip. Longer needles are not associated with more pain.
What type of risks are associated with myofascial trigger point dry needling?
The most serious risk associated with dry needling is pneumothorax (air in the space around the lungs). This is a very rare (<.01%) but serious complication and would require the patient to seek medical attention. Symptoms of pneumothorax include shortness of breath, sudden sharp pain each time you breath in, and inability to “catch your breath.” Other risks include bruising (7.55%), bleeding (4.65%), pain (.088%), headache (0.14%), nausea (0.13%), infection (<.1%).
Who performs the treatment on me? What are their qualifications?
The therapy is usually performed by a physical therapist. Not all therapists, however, can offer their clients dry needling. In most states, a practitioner must have a certain amount of education and training in the therapy before being certified to treat patients.
How many needles are used?
On average, 5-10 needles may be used to effectively treat the involved muscles. Occasionally, larger muscle groups may require the use of more needles.
Does this therapy loosen muscles or relax muscle knots?
Yes, needling can be used in tight muscles/knots in order to elicit a twitch response or muscle cramp prior to causing the muscle to relax.
Does Medicare pay for dry needling?
At this time, Medicare does not cover this therapy. In 2020, CMS proposed a final rule to add CPT codes for the therapy, however Medicare will not reimburse for these codes due to lack of studies conducted to support the use of needling. Expect change as the evidence supporting dry needling sharply increases. Some commercial insurances cover this treatment, but you may have to contact your individual insurance in order to determine coverage.
Does this release toxins?
Dry needling activates the body to release opiate peptides like beta-endorphins, enkephalins, and dynorphins. These are natural neurotransmitters that work to block transmission of pain information to the brain and spinal cord.
Are there any infection risks?
The risk of infection is extremely low (<0.1%).