It is a treatment method performed by trained health professionals (often physiotherapists) that involve a thin monofilament needle inserted into the skin. The needles used are stainless steel, very fine needles that don’t inject any fluid, hence why it’s described as “dry” needling. Trigger points, commonly known as muscle knots are often targeted during dry needling, however in some cases therapists may use dry needling for pain modulation.
So why do we target trigger points?
Trigger points are tight, hyperirritable and tender spots in muscle fibers. They can cause restriction in movement, disrupt function and cause pain locally and distally. Trigger points cause pain due to reduced blood flow to the area, causing decreased pH level in the muscle resulting increase sensitivity to pain.
How does it work?
The thin needle penetrates the skin and causes disruption of the trigger points, affecting the muscle and nerves. When dry needling is applied it can decrease the tightness of trigger points, increase blood flow and reduce pain. The needling is typically inserted in a “piston” or “pecking” like manner, muscles may sometimes twitch indicating trigger point area, however twitching varies between muscle and patient, and is not always necessary while treating the muscle.
Pain is reduced by the stimulation of chemical release locally where the needle is inserted and centrally along the brain and spinal cord.
Dry needling therapy is often used in conjunction with a wider approach in physiotherapy, by incorporating other interventions such as exercise prescription, manual therapy etc. to achieve optimal outcomes.
What does it feel like?
Patients may experience a minor pinch like sensation when the needle is inserted, a dull achy sensation may follow, especially if a twitch response is elicited. The ache can last for 24-48 hours, it generally doesn’t affect function or performance.
Here is a video showing you dry needling into the forearm: Forearm Dry Needling