Ever wonder what dry needling is, and whether it might help you overcome pain so you can get going again? I’ve been dry needling since 2009, and was the first Air Force doctor of physical therapy to begin the practice of functional dry needling with military patients, their family members, and military retirees. Below, I’ve put together a few thoughts to get you thinking and to answer some of your questions.
When looking for pain relief or relief from tight and sore muscles, dry needling can offer significant relief that can last for several days or even weeks. Sometimes a minor injury, or muscle soreness or tightness, can hang around and become chronic for no apparent reason. After a thorough functional movement assessment is complete, a doctor may choose a single location or several locations for needle placement within a region of the body. In a basic, but very real sense, the neurologic and muscular “circuitry” of the painful region is reset. Kind of like hitting the power button on an unresponsive computer. A deep ache or even a “twitch response” may be felt as the tight and spastic muscle, the “trigger point”, releases around the painful area. Pain relief may be immediate or may take a day or so to be felt, but if there has been an accurate functional movement assessment, and your doctor has established a clear medical need to administer the technique, pain relief is usually not too long in arriving.
Whether acupuncture needles or needles developed for the exclusive use of a physical therapist or chiropractor, the purpose of dry needling is primarily to ease soreness and pain, and to restore normal function and motion of a joint or region of joints. For example, consider the shoulder. Taking a look at the muscular anatomy of the shoulder quickly reveals that this one joint has direct muscular attachments all the way up to the back of the head, as well as direct muscular attachments all the way down to the tailbone. You read that correctly. The shoulder bone is directly attached to the tailbone. I’ve had many clients from all walks of life tell me, “I hold my stress in my shoulders.” So consider for a moment that if your upper trapezius muscles are tight and holding on for dear life, that might have something to do with those headaches you get when at work or at school and you are sitting and concentrating for long periods of time. And because your shoulder is attached to your lower back and rib cage, now other muscles below the shoulder may have to begin compensating for the tightness that is coming from above. Suddenly, the shoulder joint is caught between a rock and a hard place. Tightness from above and reactive tightness from below. The shoulder, neck, and even upper and lower back now all have to work extra hard just to perform daily activities like driving, laundry, taking out the trash, and reaching overhead to replace a light bulb. And big movements that require effort and skill, things like a golf swing, a volleyball spike, or a shooting a basketball quickly become too painful to perform effectively. Here in Colorado Springs we also have a growing population of rock climbers and boulderers. Chronic regional dysfunction and pain, that is, pain that is the result of several dysfunctional areas such as the neck, shoulder, and upper back, will quickly eliminate such high level athletes from competition and training. A thorough assessment of the entire region, that is, an assessment that connects all of the dots, can quickly reveal the root cause of the problem and allow a dry needle practitioner to target the specific areas that will bring the quickest and most effective relief.
The dry needling technique has been with doctors of physical therapy and chiropractors for a couple of decades. While many dry needle practitioners use acupuncture needles, this is not an acupuncture technique. Acupuncture is a highly specific technique for licensed acupuncture practitioners – a completely separate specialty – that has helped countless people find relief and improve quality of life. It primarily deals with an eastern medicine interpretation of energy fields of the body. Interestingly, western dry needling does share similarities to the ancient “Ashi” point acupuncture technique. In Ashi acupuncture, a filament needle is inserted specifically into the painful area, regardless of whether there are tight muscles or muscle spasms in that same area (also known as trigger points). Early Chinese physicians proposed that targeting non-specific painful areas by directly inserting a needle into the painful area leads to a reduction in local pain and muscle tenderness.
Dry needling, on the other hand, is fairly recent and has been developed within a western “orthodox” medical model. Practitioners of dry needling are required to first be medically licensed practitioners, which in turn requires significant and deep knowledge of human anatomy, physiology, and neurology. The favorable research suggesting dry needling has significant and lasting results has now led to doctor of physical therapy schools teaching the dry needle technique to entry level doctoral candidates. This fact alone suggests not only that there is a high degree of effectiveness, but also that there is a high level of confidence that this technique can be taught effectively and safely to new and inexperienced practitioners.
But now you might be wondering, “how do we know that it works?” So glad you asked. The short answer is that the technique has been around long enough that there is a significant and growing body of research pointing the way, and this research is taking place all over the world, not just in Colorado Springs. For instance, in the Pain Reports medical journal of April, 2021, Marcus Yu Bin Pai and his colleagues set out to determine whether dry needling is effective for shoulder pain:
“Shoulder pain is a common complaint in all ages, and it is one of the major reasons why patients consult with primary health care providers. … shoulder disorders may affect up to 70% of the population.” The researchers conclude, “We have shown that patients with chronic shoulder pain treated by dry needling had a significant improvement in pain intensity and pain interference with daily activities compared with (placebo). Improvements started 2 days after needling and persisted for at least 7 days thereafter.”
What these authors are saying is that:
- approximately 7 out of 10 people will suffer significant shoulder pain
- dry needling is effective for shoulder pain relief
- significant, noticeable relief occurred after 2 days
- pain relief and functional improvement lasted for 7 days
Remember also that the dry needle treatment in this research study did not include a prescriptive or corrective therapeutic exercise program. The researchers simply used a needle to relieve pain, then waited to see what would happen. The magic of a clinical therapeutic approach is that your doctor will then prescribe a corrective therapeutic regimen, based on specific regional movement pattern dysfunction, that will further restore and reinforce the functional gains due to the relief from the dry needle therapy. We always want to keep in view the understanding that once pain is diminished or resolved, this does not mean that healthy neuromuscular function has automatically been restored. A thorough re-integration of healthy movement patterns will need to be started immediately and reinforced over the coming days and weeks to ensure that previous unhealthy movement patterns and compensations don’t just take over again and result in a relapse into painful dysfunction. Another way of saying this is that dry needling, much like a chiropractic adjustment, massage, or even pain medicine, is largely temporary and only provides us with a window of pain-free opportunity to begin a journey of recovery that will provide long lasting effects. ‘As the research article said, pain relief lasted an average of 7 days. I’m sure many of you reading this here in Colorado have had a similar experience with practitioners who provided one or two therapeutic interventions, then sent you on your way. The relief was great while it lasted, but you quickly found that within a week or two you needed to return for another treatment. There is nothing wrong with this type of intervention as long as we see it for what it is: temporary relief from pain, stiffness, and tightness. You are not going to get long term relief without a deep understanding as a result of a thorough, head-to-toe assessment.
The real, long term effects and relief come from working together with your doctor to establish a clear restorative path for true functional movement control and efficiency. Once all the parts are working together in harmony, then the long term benefits begin to come into focus and true recovery begins to take place. In the case of a painful shoulder, for instance, once well-coordinated shoulder-blade control allows the rest of the shoulder to move freely and independently of the neck, at that point pain will typically become a thing of the past.. A medical intervention like dry needling and others listed above, again, can only provide a window of opportunity for deep change to begin to take place. Dry needling can get you started, but any long term success will be due to your commitment to the process of change.
So, is dry needling effective? Absolutely. The muscular, skeletal, and neurologic changes that occur are highly effective at relieving pain and restoring function as part of a coordinated, holistic plan that takes the whole person into account. If you are in the Colorado Springs area and would like more information concerning how dry needling can help get you the immediate relief you need to quickly get back to the things you enjoy doing, schedule a free telephone consultation on my website at drscottajones.com, or email for more information at [email protected].
Dr. Scott A. Jones, PT
Movement Performance Coach
Are you tired of the cycle of frustration, and ready to get back to your activities?