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What Is Dry Needling In Physical Therapy

But Isnt That The Same Thing As Acupuncture

What is Dry Needling?

Acupuncture and dry needling are certainly related, but more like distant cousins. It could be said that dry needling is the modern cousin of the ancient practice of acupuncture. Both use needles inserted in the skin to relieve pain and improve health, however, unlike acupuncture, which aims to treat entire body systems, dry needling treats localized muscle trigger points in bands of muscle before the pain travels to other parts of the body.

Improves Range Of Motion

Having a complete and fluid range of motion is important for everyone but essential for athletes. When dry needling releases tension and knots, it restores the blood and oxygen flow. This allows you to achieve a full range of motion. Improving overall function can reduce or eliminate discomfort, allowing you to focus on your performance and not the pain.

What To Do After The Procedure

Once you have gone through dry needling physical therapy, you need to stay well hydrated. Ensure you drink a lot of water. In the cases where your muscles become sore after the session, our therapists advise you to rest. You can also use heat, ice therapy, or take a warm bath to feel better. Adding Epsom salts in the bath can help relieve the pain.

Notably, your muscles can be very sore in the morning. However, you can feel better after a few days. The bruising from the filiform needles can last for almost a week.

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The Risks Of Dry Needling

Dry needling comes with risks. One of the problems is that it’s semi unregulated.

According to the American Physical Therapist Association, physical therapists are explicitly allowed to practice dry needling in 36 states and DC and prohibited from practicing it in six states. Eight states remain silent on the topic without laws in place.

There’s controversy surrounding how much training physical therapists have to go through in order to be certified in dry needling, compared to how much training acupuncturists receive. In some states, acupuncturists need over 3,000 hours of training, whereas a dry needling certification can be earned after just 54 hours of training, says Tang-Ritchie.

If the dry needling procedure is done by a practitioner with little training, Beldini says the risks include:

  • Soft tissue damage
  • Increase in pain and swelling in the affected tissue

What Are The Treatments

Dry Needling Archives

There are many ways physical therapists may be able to help with this treatment. Examples include:

  • Improving posture: One of the ways physical therapists can help those with TMD is to improve the position of the head and neck, which can help to relieve abnormal stress to the TMJ.
  • Improving jaw function: Physical therapists are movement specialists and the TMJ is another joint we can positively affect. Hands-on methods, also known as manual therapy, can improve joint stiffness and relax dysfunctional muscles. There are a variety of gentle, active movements that can re-teach jaw musculature to work as intended. By improving the overall amount and symmetry of movement of the joint, the TMJ can return to normal use and pain can dissipate.
  • Pain treatment: Chronic pain can be complex. Your therapist can help explain your condition, resolve musculoskeletal dysfunction, and desensitize the region if nerve sensitivity remains. Other treatments such as ultrasound, electrical stimulation, or dry needling may be implemented as well to facilitate the healing process.

If your doctor has recommended physical therapy for TMJ, that should be your first step in treatment. For many people, thats the only treatment necessary. There are some situations where more advanced treatment is necessary. For example, dental procedures, splints, or surgery may require additional consultation with dentists or oral surgeons. Your therapist would be happy to coordinate treatments as appropriate.

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Will Dry Needling Help Me

Individuals who see good results with massage, but are disappointed when the discomfort returns, will find dry needling a better way to get longer-lasting and deeper relief. Dry Needling allows us to treat almost any muscle in the body, and treat the muscle at depths impossible with other types of bodywork. Many trigger points are just too deep in the tissue for massage, even deep tissue work, to treat effectively. Dry needling is a great way to get more out of your physical therapy by allowing us to eliminate the deep knots and restrictions that have, up until now, been unreachable.

Risks And Side Effects Of Dry Needling

Although there may be some side effects after a dry needling session, complications are rare. Side effects may include:

  • Sore muscles, which may be immediate or a few hours after the session. A warm compress for 20 minutes several times a day can help soothe the area.

  • Temporary increase in the pain symptoms that the needling is meant to treat

The very rare complication associated with dry needling occurs if the needle is inserted far enough to puncture an organ, such as a lung.

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Dry Needling: What To Expect

If youre interested in experiencing the needle effect for yourself, it may be helpful to know what to expect.

The particular details of a dry needling session will depend largely on the method of dry needling your practitioner employs. For instance, if they practice deep dry needling, they may leave the needles deep in your muscles connective tissue for 1015 minutes. With superficial dry needling, your practitioner will poke your trigger points repeatedly in an in-and-out, sparrow pecking pattern until they get a local twitch response.

Most of the time, however, the needle is left in for up to 30 seconds at a time, at a depth of 5 to 10 millimeters.

Because the needles are so small, you may not feel them at all. However, once a trigger point has been poked, you will likely feel a cramp or shot of the pain you usually feel. Thats the twitch response many practitioners seek, so you may feel your muscle fibers jumping and twitching throughout the session. It shouldnt be any more painful than what youre used to.

Once you get up from the table and head to your car, you might not feel much better right away. The same old myofascial pain might still linger at first, but over the next few hours your pain may decrease and even disappear. In its place, you may feel muscle soreness akin to what you get after exercising. The next day, once the soreness has faded, you should feel considerable relief in pain and range of motion.

Is Dry Needling The Same Thing As Acupuncture

Dry Needling by a Physical Therapist

If you only compared dry needling and acupuncture with a photo, you might be stumped to identify each. Both acupuncture and dry needling use thin, stainless steel needles. For both practices, needles are inserted into the skin and both also claim to treat pain.

Thats where the similarities end. Unique qualities help differentiate the two. One practice has been used for thousands of years in traditional Chinese medicine and has some solid research supporting its effectiveness. The others been adopted in the last couple of decades.

One is believed to relieve pain, discomfort, or other issues by placing needles in specific points in the body. The other is designed to stimulate trigger points, or muscles that are irritable.

Knowing the differences can help you decide which type of treatment is right for you.

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How Will Dry Needling Help You

Anyone experiencing body aches can benefit from dry needling. Such as athletes wishing to return to the field, to those who have collided in car accidents.

Itâs a powerful technique because it allows experienced users to treat almost any muscle in the body at depths impossible with other methods.

There are endless trigger points too deep in the tissue to reach through massaging. You can get the most out of dry needling by eliminating deep knots and restrictions that are otherwise unreachable.

Dry Needling Is Part Of A Larger Treatment Plan

Dry needling is not actually an alternative treatment. It is accepted as part of modern medicine following western medicine principles. One of the ways dry needling became commonly accepted as a western medical technique was quite accidental.

When physicians were researching the impact of various medicines on muscle pain and trigger points, researchers would use a dry hypodermic needle as a control or placebo. What was discovered was that individuals benefited simply from having a needle inserted into specific sites of dysfunction and trigger points.

With trigger point dry needling, a physical therapist treats dysfunctions in skeletal muscle, fascia and connective tissues. Needles are often placed into myofascial trigger points, which are taut bands of skeletal muscle located within a larger muscle group .

Physical Therapists that use dry needling as part of patient treatment plans have had extensive training in Anatomy, Physiology, Pathophysiology, Biomechanics, and safe Dry Needling techniques. Therapists typically use Dry Needling as part of a comprehensive plan that includes other manual therapies, therapeutic exercises, and patient education. We often add electrical stimulation to the Dry Needling treatment to increase the impact of the process.

What conditions are treated by dry needling?

Dry needling is a safe and effective way to treat many chronic and acute conditions. These include but are not limited to:

  • Temporomandibular pain/dysfunction

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What You Should Know About Dry Needling

Dry needling is used alongside other therapies to treat many conditions, including:

  • Carpal tunnel syndrome, a condition of the hand and fingers caused by a pinched nerve
  • Face and jaw pain
  • Fibromyalgia, muscle pain that includes fatigue, sleep, memory and mood issues
  • and sprain, including plantar fasciitis, inflammation of the tissue that connects the heel bone to the toes

What Problems Can Dry Needling Deal With

Dry Needling

Dry needling can be a useful treatment for muscle pain, although it must be considered no more than an adjunct to a multidimensional approach to treatment for complete recovery. Most treatments, when used alone, offer only temporary relief and can fail altogether.

Dry needling physical therapy is believed to be effective in the management of certain conditions including:

  • Acute and chronic tendonitis

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What Are The Risks And Potential Complications Of Dry Needling

Dry needling is a fairly safe procedure, but there are some people who should not undergo dry needling. These include:

  • People with a needle phobia

  • People who are unable to understand the treatment and may move or become agitated

  • Pregnant women, as more research on the safety of dry needling is suggested, even when avoiding historical “forbidden” acupuncture points believed to stimulate miscarriage or early labor.

People taking blood thinners or who have recently had surgery should discuss the procedure with their doctor before undergoing dry needling.

Difference Between Dry Needling And Acupuncture

Acupuncture and dry needling both puncture the skin using needles with the common aim of pain relief. However, dry needling is more focused towards removing the knots and tension arising in the trigger points in the body. In contrast, acupuncture inserts needles to affect the person’s nervous system to synchronize their chi and energy.

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Benefit #: Relieved Muscle Spasms And Stress

If you suffer from chronic muscle tension and convulsions, dry needling can help relieve the pain and stiffness you experience. Your physiotherapist will insert the filament into the hypertonic muscles and physically turn it to release the stress. Your therapist may also use minor pressure and stretch your muscles, which can help alleviate your pain and convulsions.

What Does Dry Needling Feel Like

Dry Needling In Physical Therapy

The needles used in Dry Needling are very thin and flexible. They are designed to be pushed through the skin and not cut the skin. Most patients feel a little pressure of the needle, but sometimes a muscle twitch is elicited. This may be felt as an electrical shock, muscle ache, or cramp. This is a normal sensation and even a desirable response because the area of dysfunction is being targeted. Patients may also feel tired or relaxed after treatment because of the effect on the nervous system. Occasionally, patients may have small amounts of bruising at the insertion site and muscles could feel sore for 1-2 days. Your physical therapist will review all this information with you as well prior to your treatment.

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How Will I Know If The Treatment Worked

You may feel immediate effects following the Dry Needling session on the same day or several days later. Subsequent treatments may focus on the same treatment area or a different area depending on how you responded to your session. This is patient specific and will be individualized for each patient.

If you have questions regarding Dry Needling or are interested in learning more about pelvic floor physical therapy, Urology Austin Physical Therapists are available at designated locations. Speak with your urologist about the benefits of physical therapy and if physical therapy would be a choice for you for treatment. Thank you for entrusting Urology Austin with your urological health care needs.

Learn more about our Pelvic Floor Physical Therapists

Dry Needling Risks And Side Effects

Mild side effects are very common with dry needling, but serious side effects are rare. The most common side effects around the injection site include:

  • Temporary bleeding at site of needle insertion
  • Temporary soreness

Does dry needling hurt?

We are often asked what dry needling feels like, and whether or not it hurts. Having a thin monofilament or filiform needle inserted through your skin and into a muscle is relatively painless. You might feel the initial prick but not much else. As the needle moves into the muscle, patients may often feel the muscle twitch, a sense of warmth, or a mild deep ache.

With the application of electrical stimulation patients report feeling some tingling ad or a rhythmic muscle contraction, not unlike use of a TENS unit but deeper. Once needles are removed there may be a small amount of bleeding, but not very much.

Additional responses to dry needling may include a sense of relaxation or fatigue as the body reacts to the central nervous system and biochemical impact of the needles. Sometimes, there may be some achiness in the muscle and on occasion a small bruise. If dry needling is going to be helpful, you will know within a few sessions.

If youve been considering dry needling in response to your pain, please reach out to us. We would be happy to answer any questions you have and provide a free consultation if you would like.

Jeffrey Petersen, PT, MOMT

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Is Dry Needling Right For You

Only your physical therapist can determine if dry needling is appropriate for you. However, it can help virtually anyone who experiences chronic or repetitive muscle pain. Dry needling is particularly popular among physically active individuals, such as those who do CrossFit. Your physical therapist can perform dry needling to relieve a range of conditions, including back pain, neck pain, shoulder and arm pain, and hip and leg pain.

How can you tell if you have a trigger point that can benefit from dry needling? You might develop a variety of symptoms, most notably acute or chronic muscle pain and restricted range of motion. If you press on the trigger point itself, it will feel like a hard knot or a small marble under the skin. Note that some people report suffering from pain, sometimes intense, when pressing on a trigger point, while other people do not. As a result, you might not know that you have a trigger point until you go to a physical therapist for an evaluation.

How Will I Feel After Dry Needling

Dry Needling Services

You will know positive change has occurred right after the session, as you should have decreased pain and increased mobility and because you will be sore in the way that you would feel after a heavy work out. The muscle will feel fatigued, and the soreness can last from a few hours to 1 or 2 days, but should not interfere with your everyday activities. We encourage you to be active during this time to keep the soreness to a minimum. You can continue your normal activities and gym routine. After a day or so, youll experience a new and lasting feeling of less pain and tightness. The injury and pain you thought was there to stay will actually start to diminish. If youve been having long standing, chronic muscle pain wed welcome the opportunity to explain this treatment option in more detail and answer any questions you may have.

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Is Dry Needling Like Acupuncture

While dry needling sounds very similar to acupuncture, the practice is quite different in origin and application. The only common element is the equipment used to administer the needles.

Acupuncture is a form of eastern medicine that originated in China. Acupuncture uses an invisible map of meridian lines on the body that determine where the needles should be inserted. It is based on the concept of qi which is the flow of energy throughout the body. The needles are placed to unblock areas of the body where energy is blocked and causing pain.

Dry needling is part of western medicine that involves different training. Practitioners who administer dry needling learn to identify the trigger points in the muscles that are the source of pain for the patient. Trigger point location is based on information from the patient and medical testing that reveals orthopedic issues that may be the cause of the patients pain.

How Does Dry Needling Treat Trigger Point Pain

A physical therapist will take a thin, unmedicated filiform needle to penetrate the skin, deep into the muscle tissue. The needle will stimulate the underlying myofascial trigger point and the surrounding areas. That tight band of oxygen-deprived scar tissue, when a needle is inserted into it, will produce whats called a twitch reflex. The twitch reflex decreases muscle contraction, reduces irritation and pain, and also improves flexibility. A lesion will form from the needle which cuts through 15,000 muscle fibers.

The body thinks the needle is a foreign invader, and it activates the immune system. Cut muscle fibers then produce an inflammatory reaction that helps to reduce inflammation all through the body, not just at the site of the penetrated trigger point.

Trigger points are incredibly difficult to manipulate and treat manually. A physical therapist can trigger and target tissues that they otherwise could not stimulate manually when they use dry needling.

Dry needling is also relatively painless, but during the local twitch response, you may feel a slight cramping or aching sensation. This is brief and indicates that the method is working to stimulate the muscle fibers and produce an immune system response.

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