DRY NEEDLING

References

Thank You for your time!

Any Questions?

1. Rugerri, Christine. (2016, April 3). Dry Needling Relieves Muscle Pain and More. Retrieved from https://draxe.com

2. Ries, Eric. (2015, May). Dry Needling: Getting to the Point. Retrieved from https://apta.org

3. Shah JP, Danoff JV, Desai MJ, et al. Biochemicals associated with pain and inflammation

are elevated in sites near to and remote from active myofascial trigger points. Arch Phys

Med Rehabil. Jan 2008;89(1):16-23

4. . Kuan TS, Hsieh YL, Chen SM, Chen JT, Yen WC, Hong CZ. The myofascial trigger point

region: correlation between the degree of irritability and the prevalence of endplate noise.

Am J Phys Med Rehabil. 2007;86(3):183-189.

5. Hong CZ. Lidocaine injection versus dry needling to myofascial trigger point. The importance

of the local twitch response. Am J Phys Med Rehabil. 1994;73(4):256-263.

When is dry needling an indicated intervention for treatment?

How does it work physiologically?

• Myofascial trigger points
• Fascial adhesions or scar tissue
• Conditions: Migraines, TTH, CRPS, Carpal Tunnel Syndrome, Radiculopathies, Tendonitis, Spinal dysfunction, pelvic pain, whiplash associated disorders...etc

Techniques

http://www.apta.org/StateIssues/DryNeedling/ClinicalPracticeResourcePaper/

What is dry needling?

http://www.apta.org/StateIssues/DryNeedling/ClinicalPracticeResourcePaper/

Superficial

• Inserted: dermis/epidermis
• Pros: less likely to cause muscle soreness, still get the neurological/physiological effect

Deep

• Inserted: through the dermis/epidermis, fascia, and muscle tissue
• Pros: elicit the neurophysiological effect

Needle Manipulation

- rotation, tenting, pistoning

DRY NEEDLING

How is it performed?

Millie Obregon, SPT

1. Get consent from the patient

2. With gloves on, palpate the muscle for the trigger point

3. Apply the filiform needle in it's tube against the suspected area.

4. Tap or flick the needle, allowing the needle to penetrate the skin

https://integrativedryneedling.com/clinical-dosage-dry-needling/

https://www.everydayhealth.com/columns/my-health-story/dry-needling-most-painful-thing-ever-loved/

Side Effects

• Dry needling is a skilled physical therapy intervention using a thin filiform needle that is inserted into myofascial trigger points (painful knots in muscles), tendons, ligaments, or near nerves in order to stimulate a healing response in painful musculoskeletal conditions.

Bruising

Bleeding

Temporary soreness

Pneumothorax (rare)

What is the incidence of adverse effects?

• less than 10% of those who receive this treatment have an adverse effect
• incidence changes based on body part/area receiving the treatment

http://www.apta.org/StateIssues/DryNeedling/ClinicalPracticeResourcePaper/

What does the evidence say?

http://www.apta.org/StateIssues/DryNeedling/ClinicalPracticeResourcePaper/

• Local skin lesions must be avoided with DN.
• Local or systemic infections are generally considered to be contraindicated.
• Local lymphedema (note: there is no evidence that DN would cause or contribute to increased lymphedema, ie, postmastectomy, and as such is not a contraindication).
• Severe hyperalgesia or allodynia may interfere with the application of DN, but should not be considered an absolute contraindication.
• Patients with significant cognitive impairment
• Obesity
• Pregnant patient

What states is it legal for PT's to perform dry needling?

What are the benefits of Dry Needling?

http://www.apta.org/StateIssues/DryNeedling/ClinicalPracticeResourcePaper/

Is there a difference between acupuncture and dry needling?

YES! Dry needling is used to treat pain and dysfunction in MSK conditions whereas acupuncture is used for the purpose of altering the flow of energy ("chi") for the treatment of diseases

Does dry needling have an effect on the lymphatic system?

There is limited evidence on the effects of dry needling on the lymphatic system

What is the appropriate dosing of dry needling?

Differs between deep and superficial dry needling

Does it suffice as a stand alone treatment?

No! It should be used in conjuction with STM, therapeutic exercises, functional retraining

http://www.apta.org/StateIssues/DryNeedling/ClinicalPracticeResourcePaper/

Dry Needling in Florida

Reduces pain

A 2007 study published in the American Journal of Physical Medicine and Rehabilitation suggests that dry needling significantly reduced shoulder pain

Improves movement

A 2010 case report published in Acupuncture in Medicine treated four international female volleyball athletes during a month-long intense competitive phase with dry needling therapy.

Speeds up recovery

A study conducted at the University of Queensland in Australia investigated the effectiveness of dry needling for chronic whiplash, which is associated with sensory hypersensitivity and has poor responsiveness to physical treatments such as exercise.

https://www.myharrisregional.com/Content/Uploads/Harris%20Regional%20Hospital/files/What%20to%20Expect%20after%20Functional%20Dry%20Needling-CWSM.pdf

http://www.apta.org/PTinMotion/2015/5/DryNeedling/

https://www.fpta.org/general/custom.asp?page=18214dryneedling