Dry Needling: Your questions answered
It has become increasingly common for physiotherapists to use dry needling as part of the treatment regime for a range of sports injuries and painful muscle and joint conditions. While more and more people may have heard of, or even experienced needling, many are still unsure what it actually involves and what role it could play in helping their own pain or injury. Scott Palmer, APA Sports Physiotherapist and Co-director at The Physio Studio, answers some of those questions in this months blog.
What is dry needling?
Dry needling involves inserting very small solid acupuncture needles, into the skin, muscles or ligaments to create a response in the body. It is commonly used to help address muscle tightness or tension, persistent connective tissue irritation, swelling or pain. It differs to traditional acupuncture as it targets specific anatomical structures, including the myofascial, or muscle “trigger points”, rather than treating along the principles of traditional Eastern medicine. The term “dry” in the name refers to the fact that no substance is being injected, rather the needle itself mechanically stimulates the body part.
How does it work?
When addressing muscle tightness, the needle is inserted into the tight bands of the muscle belly, often referred to as a trigger point. This causes the muscle to contract momentarily, known as a “twitch response”. The tight muscle then relaxes more effectively producing a reduction in pain and tension. Needling can also be used without targeting a twitch response; to help pain or swelling, to help general relaxation or for treating cartilage degeneration. These benefits may come from stimulating blood flow and activating the nervous system.
What conditions can it be used for?
Dry needling usually forms just one part of the overall physiotherapy treatment regime for clients and may be accompanied by other hands-on treatment techniques, exercises and education about the condition. Common conditions that needling could assist with include
- Neck pain or tension headaches
- Shoulder rotator cuff problems
- Tennis or golfers elbow.
- Low back pain
- Gluteal, piriformis issues or hip bursitis
- ITB related pain
- Knee joint problems
- Shin splints or plantar fasciitis
- A range of other conditions involving muscle tension, persistent pain or swelling
Are there any side effects or risks?
When performed by trained physiotherapists, the treatment is very safe. As with any treatment, side effects are possible and minor side effects can include increased pain, local bleeding or bruising, post treatment drowsiness, fainting, nausea and dizziness. More serious complications are very rare and can be explained by your therapist.
How many needles do you use?
This depends on the nature of the problem and the body part being treated. For example, to help relax the upper trapezius muscles when treating neck pain, 2 or 3 needles may be used on either side of the neck, whereas needling for a chronic hip/thigh problem could involve the use of 10+ needles to address all the muscle groups targeted. Generally speaking, if you are having needling for the first time, your physio is more likely to use just a few needles and for a shorter duration to check your response.
How long do they stay in for?
Usually for anywhere between 5 to 15 minutes, depending on the goal of the technique. The needling can have a relaxing affect not only on the local muscle but also on the patient more generally, including lowering blood pressure. Leaving the needles in longer may amplify this effect, which could be positive or negative depending on the client’s health status.
How many treatments do you need?
The benefits of needling should be clear after no more than a couple of sessions. If effective then repeating the needling over a few sessions can be helpful, or alternatively some clients and athletes may come in intermittently for treatment to stay on top of a problem area that tends to tighten due to their sport or regular activities.
Does it hurt?
Dry needling involves using very fine needles (around 0.2mm wide), so the feeling when inserted into the skin is like a fine pin prick sensation. Some needles tend to be felt more than others. If a “twitch response” is elicited then this can feel stronger and is often described as an odd, nervy sensation.
Is it suitable for everyone?
Generally needling is safe and suitable for a large percentage of the population. There are a number of specific conditions or client types who may not be suitable for needling including those with a strong needle phobia, those taking strong blood thinning medication, who have a blood clotting disorder, during the first trimester of pregnancy, in patients who have had recent surgery, or a past history of systemic infection.
But what if i hate needles?
The goal of using needling for most people is to promote muscle relaxation, reduce tone and decrease pain. If a client is particularly anxious they are less likely to be able to relax and feel the benefits so dry needling may not be suitable for all patients. For those who are a bit nervous but are still open to the potential benefits, the physio may discuss the option of trialling 1 or 2 very fine needles initially.
How do i book a time?
You can book an appointment with one of our physio team trained in dry needling by contacting the clinic on 8357 0418 or simply book online and mention in the booking note that you are interested in needling.